FREQUENCY OF DIABETES MELLITUS TYPE II IN RHEUMATOID ARTHRITIS PATIENTS PRESENTING AT A TERTIARY CARE HOSPITAL IN KARACHI: A CROSS-SECTIONAL STUDY

Abstract

Background: Rheumatoid arthritis (RA) is a chronic inflammatory condition associated with increased risk of comorbidities, including type 2 diabetes mellitus (T2DM), due to systemic inflammation, glucocorticoid use, and metabolic alterations. Data on T2DM prevalence in RA patients from Pakistan remain limited.

Objective: To determine the frequency of T2DM in patients with RA and explore its association with sociodemographic and clinical variables.

Methods: This cross-sectional study was conducted at the outpatient department of Jinnah Postgraduate Medical Center, Karachi, Pakistan, from March to September 2025. A total of 137 newly diagnosed RA patients (aged 30–70 years) fulfilling the 2010 ACR/EULAR classification criteria were included using non-probability consecutive sampling. Exclusion criteria encompassed pre-existing thyroid disorders, other connective tissue diseases, malignancy, pregnancy, and major comorbidities. HbA1c ≥6.5% was used to diagnose T2DM. Data on demographics, anthropometrics, and lifestyle factors were collected. Analysis was performed using SPSS v27.0, with chi-square tests for associations (p ≤0.05 significant).

Results: The mean age was 57.61 ± 10.44 years; 55.5% were male, and mean BMI was 29.34 ± 5.11 kg/m². T2DM was present in 37 patients (27.0%). Significant associations were observed with obesity (p=0.05), unemployment (p=0.02), and lower educational status (p=0.05). No significant associations were found with age, gender, residence, smoking, or family income.

Conclusion: The prevalence of T2DM in this Pakistani RA cohort (27.0%) is notably higher than many global estimates and aligns with the role of chronic inflammation and traditional risk factors. Obesity, unemployment, and limited education emerged as key associated factors. These findings highlight the need for routine metabolic screening (e.g., HbA1c) in RA patients to enable early intervention and reduce cardiometabolic complications.