Diabetes mellitus and gout

Abstract Gout is the most common inflammatory arthritis with rising prevalence and incidence globally, especially in men, owing to longevity, changing dietary and lifestyle factors, obesity and increasing comorbidities. Both gout and diabetes mellitus (DM) are independent risk factors for cardiovascular diseases and mortality. Contrary to popular beliefs that the relationship are positive bidirectionally, several large scale prospective epidemiological studies showed that DM appears to decrease risk of incident gout whereas gout is associated with increased risk of incident DM. Underlying the link are uric acid (or hyperuricemia) and insulin resistance, where the pathophysiology can be explained by multiple mechanisms including oxidative stress, inflammation, fructose intake, genetics and urate transporters. Although the treatment of gout is seemingly straightforward, outcomes remain poor. Given their correlation, it is imperative to screen for concomitant metabolic risk factors and ensure optimal treatment of both diseases so as to provide person-centered, holistic care.