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Despite major advances in RA treatment over the past two decades, patients with rheumatoid arthritis remain significantly more likely to develop diabetes than those without the condition. A large VA study found RA patients face a 17% higher diabetes risk, with steroids and elevated inflammation markers pushing that risk even higher. Researchers say the relative risk hasn't budged in 20 years.
Despite major leaps in how we treat rheumatoid arthritis, the elevated diabetes risk that comes with the condition hasn't budged in two decades. That's the key finding from a large retrospective study presented at ACR Convergence 2026, which analyzed Veterans Affairs data spanning 2000 to 2022.
Researchers matched nearly 24,000 RA patients to over 185,000 non-RA controls and tracked them for an average of 9.1 years. Even after adjusting for confounders, RA patients were 17% more likely to develop diabetes — and the risk climbed higher for those on steroids or with elevated inflammatory markers like ESR/CRP.
By the Numbers:
Why it matters: Rheumatologists and primary care providers need to prioritize diabetes screening in RA patients and minimize glucocorticoid use wherever possible. With cardiovascular disease already a leading cause of death in RA, the added metabolic burden of diabetes makes proactive monitoring and steroid-sparing strategies essential for this high-risk population.
