The Management of Diabetes with Hyperuricemia: Can We Hit Two Birds with One Stone?

Overview

Journal J Inflamm Res

Publisher Dove Medical Press

Date 2024 Jan 1

PMID 38161355

Authors

Yunyang Wang

Jie Lu

Affiliations

Soon will be listed here.

Abstract

Serum urate (SU) is an independent predictor for the incidence of diabetes. In current diabetes treatment regimens, there is insufficient appreciation of the importance of hyperuricemia (HU) in disease control and prevention. To summarize the updated knowledge on the effects of SU on β-cell function, insulin resistance and chronic diabetic complications, as well as to evaluate the management of patients with both HU and diabetes, we searched the MEDLINE PubMed database, and included 285 journal articles. An inverted U-shaped relationship between fasting plasma glucose and SU levels was established in this review. Elevated SU levels may enhance the development of chronic diabetic complications, including macrovascular and microvascular dysfunction. Diet and exercise are essential parts of the lifestyle changes necessary for HU and diabetes management. Glucose- and urate-lowering drug selection and combination should be made with the principle of ameliorating, and at least not deteriorating, diabetes and HU. Medical artificial intelligence technology and monitoring systems can help to improve the effectiveness of long-term management of HU and diabetes through digital healthcare. This study comprehensively reviews and provides a scientific and reliable basis for and viewpoints on the clinical management of diabetes and HU.

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References

Zhao Y, Xu L, Tian D, Xia P, Zheng H, Wang L . Effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on serum uric acid level: A meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2017; 20(2):458-462. DOI: 10.1111/dom.13101. View

Niu S, Chang K, Lin H, Kuo I, Chang Y, Chen Y . Decreased incidence of gout in diabetic patients using pioglitazone. Rheumatology (Oxford). 2017; 57(1):92-99. DOI: 10.1093/rheumatology/kex363. View

Lv Q, Meng X, He F, Chen S, Su H, Xiong J . High serum uric acid and increased risk of type 2 diabetes: a systemic review and meta-analysis of prospective cohort studies. PLoS One. 2013; 8(2):e56864. PMC: 3577701. DOI: 10.1371/journal.pone.0056864. View

Dugstad J, Eide T, Nilsen E, Eide H . Towards successful digital transformation through co-creation: a longitudinal study of a four-year implementation of digital monitoring technology in residential care for persons with dementia. BMC Health Serv Res. 2019; 19(1):366. PMC: 6558683. DOI: 10.1186/s12913-019-4191-1. View

Tanaka A, Taguchi I, Teragawa H, Ishizaka N, Kanzaki Y, Tomiyama H . Febuxostat does not delay progression of carotid atherosclerosis in patients with asymptomatic hyperuricemia: A randomized, controlled trial. PLoS Med. 2020; 17(4):e1003095. PMC: 7176100. DOI: 10.1371/journal.pmed.1003095. View

Rheinheimer J, de Souza B, Cardoso N, Bauer A, Crispim D . Current role of the NLRP3 inflammasome on obesity and insulin resistance: A systematic review. Metabolism. 2017; 74:1-9. DOI: 10.1016/j.metabol.2017.06.002. View

Bartakova V, Kuricova K, Pacal L, Nova Z, Dvorakova V, Svrckova M . Hyperuricemia contributes to the faster progression of diabetic kidney disease in type 2 diabetes mellitus. J Diabetes Complications. 2016; 30(7):1300-7. DOI: 10.1016/j.jdiacomp.2016.06.002. View

Yisireyili M, Hayashi M, Wu H, Uchida Y, Yamamoto K, Kikuchi R . Xanthine oxidase inhibition by febuxostat attenuates stress-induced hyperuricemia, glucose dysmetabolism, and prothrombotic state in mice. Sci Rep. 2017; 7(1):1266. PMC: 5430858. DOI: 10.1038/s41598-017-01366-3. View

Tomiyama H, Shiina K, Vlachopoulos C, Iwasaki Y, Matsumoto C, Kimura K . Involvement of Arterial Stiffness and Inflammation in Hyperuricemia-Related Development of Hypertension. Hypertension. 2018; 72(3):739-745. DOI: 10.1161/HYPERTENSIONAHA.118.11390. View

10.

Stack A, Dronamraju N, Parkinson J, Johansson S, Johnsson E, Erlandsson F . Effect of Intensive Urate Lowering With Combined Verinurad and Febuxostat on Albuminuria in Patients With Type 2 Diabetes: A Randomized Trial. Am J Kidney Dis. 2020; 77(4):481-489. PMC: 8045740. DOI: 10.1053/j.ajkd.2020.09.009. View

11.

Braga T, Forni M, Correa-Costa M, Ramos R, Barbuto J, Branco P . Soluble Uric Acid Activates the NLRP3 Inflammasome. Sci Rep. 2017; 7:39884. PMC: 5233987. DOI: 10.1038/srep39884. View

12.

Pilemann-Lyberg S, Hansen T, Tofte N, Abitz Winther S, Theilade S, Ahluwalia T . Uric Acid Is an Independent Risk Factor for Decline in Kidney Function, Cardiovascular Events, and Mortality in Patients With Type 1 Diabetes. Diabetes Care. 2019; 42(6):1088-1094. DOI: 10.2337/dc18-2173. View

13.

Hu F, Zhang T . Study on Risk Factors of Diabetic Nephropathy in Obese Patients with Type 2 Diabetes Mellitus. Int J Gen Med. 2020; 13:351-360. PMC: 7352450. DOI: 10.2147/IJGM.S255858. View

14.

Bjornstad P, Wadwa R, Sirota J, Snell-Bergeon J, McFann K, Rewers M . Serum uric acid and hypertension in adults: a paradoxical relationship in type 1 diabetes. J Clin Hypertens (Greenwich). 2014; 16(4):283-8. PMC: 3989383. DOI: 10.1111/jch.12305. View

15.

Liu X, Wu Q, Chen Z, Yan G, Lu Y, Dai H . Elevated triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio increased risk of hyperuricemia: a 4-year cohort study in China. Endocrine. 2020; 68(1):71-80. DOI: 10.1007/s12020-019-02176-5. View

16.

Choi H, Soriano L, Zhang Y, Garcia Rodriguez L . Antihypertensive drugs and risk of incident gout among patients with hypertension: population based case-control study. BMJ. 2012; 344:d8190. PMC: 3257215. DOI: 10.1136/bmj.d8190. View

17.

Aktas G, Kocak M, Bilgin S, Atak B, Duman T, Kurtkulagi O . Uric acid to HDL cholesterol ratio is a strong predictor of diabetic control in men with type 2 diabetes mellitus. Aging Male. 2019; 23(5):1098-1102. DOI: 10.1080/13685538.2019.1678126. View

18.

Kocak M, Aktas G, Erkus E, Sincer I, Atak B, Duman T . Serum uric acid to HDL-cholesterol ratio is a strong predictor of metabolic syndrome in type 2 diabetes mellitus. Rev Assoc Med Bras (1992). 2019; 65(1):9-15. DOI: 10.1590/1806-9282.65.1.9. View

19.

Lytvyn Y, Perkins B, Cherney D . Uric acid as a biomarker and a therapeutic target in diabetes. Can J Diabetes. 2015; 39(3):239-46. DOI: 10.1016/j.jcjd.2014.10.013. View

20.

Bjornstad P, Laffel L, Lynch J, El Ghormli L, Weinstock R, Tollefsen S . Elevated Serum Uric Acid Is Associated With Greater Risk for Hypertension and Diabetic Kidney Diseases in Obese Adolescents With Type 2 Diabetes: An Observational Analysis From the Treatment Options for Type 2 Diabetes in Adolescents and Youth.... Diabetes Care. 2019; 42(6):1120-1128. PMC: 6609951. DOI: 10.2337/dc18-2147. View