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Type 2 Diabetes and Psoriasis Connection Appears Strong

Type 2 diabetes and psoriasis

Among all the risk factors for type 2 diabetes--obesity, high triglycerides, insulin resistance, and others--one that seems unlikely is the skin condition called psoriasis. Yet findings of a new meta-analysis support and enhance the connection between type 2 diabetes and psoriasis.

What is the link between diabetes and psoriasis?

Researchers have been on the trail of a connection between type 2 diabetes and psoriasis for a few years. One earlier study, for example, noted that diabetes and hypertension were more common among people who had psoriasis compared with those without psoriasis.

In subsequent research, a meta-analysis of 22 studies reported that individuals with psoriasis had a 1.42-fold increased risk of diabetes compared with people without the skin condition. Earlier in 2012, a study from the United Kingdom that reviewed data on more than 500,000 people indicated that having psoriasis is a risk factor for type 2 diabetes.

Now a study headed by April Armstrong, assistant professor of dermatology at the University of California, Davis, and her team reports that the connection between type 2 diabetes and psoriasis appears to be strong. They based their conclusion on an evaluation of 27 studies that included more than 314,000 people with psoriasis and compared them with 3.7 million who did not have the skin condition (controls).

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Of the 27 studies, five assessed prevalence (number of people who developed diabetes during the study) and 22 evaluated the incidence of diabetes at the start of the study. Here is a rundown of what the researchers found:

  • Individuals with mild psoriasis have a greater than 1.5-fold increased risk of developing type 2 diabetes compared with controls
  • Individuals with severe psoriasis are twice as likely to develop type 2 diabetes than are controls
  • Of the 5 studies that evaluated prevalence, individuals with psoriasis had a 27 percent increased risk of developing diabetes when compared with controls
  • Ethnicity and where individuals lived (country) did not have an impact on the rate of diabetes

Why this study is important
Armstrong noted that their findings "suggest an underlying physiological link between the two diseases," and more research will be necessary to identify what that relationship is. One avenue of research involves fat cells, which Armstrong noted may not function normally in people with psoriasis.

"These cells secrete inflammatory substances known as cytokines that increase insulin resistance in the liver and muscle and initiate destruction of insulin-producing cells in the pancreas," she explained.

The estimated 25.8 million Americans with diabetes are at increased risk for heart disease and stroke, while the 7.5 million with psoriasis are also at higher risk for these conditions. The findings of this and previous studies concerning type 2 diabetes and psoriasis are important for both patients and healthcare providers so they can take steps to effectively address the associated risks.

American Diabetes Association
Armstrong AW et al. Psoriasis and the risk of diabetes mellitus: a systematic review and meta-analysis. Archives of Dermatology 2012 Oct. doi:10.1001/2013.jamadermatol.406
Cheng J et al. Psoriasis increased the risk of diabetes: a meta-analysis. Archives of Dermatologic Research 2012 Mar; 304(2): 119-25
Ghiasi M et al. Psoriasis and increased prevalence of hypertension and diabetes mellitus. Indian Journal of Dermatology 2011 Sep-Oct; 56(5): 533-36
Rahat SA et al. Increased rate of diabetes mellitus and likelihood of receiving diabetes mellitus treatment in patients with psoriasis. Archives of Dermatology 2012; 1-6. doi: 10.1001/archdermatol.2012.1401

Image: Wikimedia Commons