Awareness Spotlight: Understanding the Diabetes-Lupus Connection

For millions of people, a diagnosis of a chronic disease is a call to action—to learn, to adapt, and to manage their health proactively. When conditions like diabetes and systemic lupus erythematosus (SLE), or lupus, intersect, the need for awareness and vigilance becomes even more critical.

Both diabetes and lupus are complex, systemic conditions. For those managing lupus, there is a distinct and important link to be aware of regarding blood sugar regulation and diabetes risk.

🔬 The Two-Sided Link Between Lupus and Diabetes

While the underlying causes of the two diseases are different, they share a relationship that can affect a person's health in two main ways:

1. Increased Risk of Type 2 Diabetes

Studies suggest that individuals with lupus may have an increased risk of developing Type 2 Diabetes compared to the general population. This is due to a few key factors:

• Inflammation and Insulin Resistance: Lupus is an autoimmune disease characterized by chronic inflammation throughout the body. This systemic inflammation can lead to insulin resistance, where the body’s cells don't respond effectively to insulin, causing blood glucose levels to rise.

• Corticosteroid Use: A cornerstone of lupus treatment, glucocorticoids (corticosteroids) like prednisone are powerful medications used to control inflammation and suppress the immune system. However, long-term or high-dose use of these medications is a well-known factor that can increase blood sugar levels and contribute to the development of diabetes.

2. Autoimmune Overlap (Type 1 Diabetes)

Lupus and Type 1 Diabetes (T1D) are both autoimmune diseases. T1D occurs when the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas.

As we often say here at MTL, autoimmune diseases like to "party together." It's common for a person with one autoimmune condition to develop another. For some lupus warriors, the autoimmune process may extend to the pancreas, leading to the development of Type 1 Diabetes. The presence of both conditions can significantly complicate management and treatment plans.

🛡️ Take Control: What You Can Do

If you are a lupus patient or care for someone who is, being aware of this connection empowers you to be an effective advocate for long-term health.

1. Be Vigilant for Symptoms

Diabetes symptoms can sometimes be subtle or overlap with general fatigue experienced during a lupus flare. If you notice any of these signs, speak with your doctor immediately:

• Excessive thirst and frequent urination

• Unusual or unexplained weight loss

• Increased hunger

• Blurred vision

• Fatigue that is more severe than usual

• Sores that heal slowly

2. Prioritize Lifestyle Management

A healthy lifestyle is crucial for managing both lupus and diabetes risk:

• Nutrition: Focus on a balanced diet rich in whole foods, managing carbohydrate intake, and avoiding excessive sugar. An anti-inflammatory diet can support both conditions.

• Movement: Regular, moderate physical activity helps improve insulin sensitivity and manage weight, which is particularly important as long-term steroid use can cause weight gain. Always discuss a new exercise plan with your rheumatologist.

• Manage Corticosteroids: Work closely with your doctor to take the lowest effective dose of glucocorticoids for the shortest time necessary. Never stop taking your prescribed steroids suddenly, as this can be dangerous.

3. Talk to Your Healthcare Team 🤝

Communication is your most powerful tool.

• Regular Screening: Talk to your rheumatologist and primary care physician about regular blood sugar screenings, especially if you have other risk factors for diabetes (such as a family history).

• Medication Review: Discuss any concerns you have about blood sugar changes related to your lupus medications. Ask your doctor if a GLP-1 medication might be helpful.

• Complication Awareness: Both lupus (especially lupus nephritis) and diabetes can damage the kidneys and increase the risk of cardiovascular disease. Managing one condition well directly helps protect against complications from the other.

By understanding the link between lupus and diabetes and taking proactive steps, you can better manage your overall health and live a fuller, healthier life.

Compiled by:

Kelli (Casas) Roseta

**All resources provided by this blog are for informational purposes only, not to replace the advice of a medical professional. Kelli encourages you to always contact your medical provider with any specific questions or concerns regarding your illness. All intellectual property and content on this site and in this blog are owned by morethanlupus.com. This includes materials protected by copyright, trademark, or patent laws. Copyright, More Than Lupus 2025.

🔗 Sources:

• Systematic Review and Meta-analysis on Diabetes Risk in SLE: This paper investigates the overall risk of Diabetes Mellitus in SLE patients and notes the opposing effects of certain lupus medications.

  • Source: Mendoza-Pinto, C., et al. (2024). Risk of diabetes mellitus in systemic lupus erythematosus: systematic review and meta-analysis. Rheumatology (Oxford, England).

  • Link: https://pubmed.ncbi.nlm.nih.gov/38552312/

• Review on Insulin Resistance and T2DM in SLE: This article summarizes the evidence linking chronic inflammation in lupus to increased insulin resistance, which can lead to Type 2 Diabetes.

  • Source: Uribe, L., et al. (2023). Insulin Resistance and Diabetes Mellitus in Patients with Systemic Lupus Erythematosus. Endocrine, Metabolic & Immune Disorders Drug Targets.

  • Link: https://pubmed.ncbi.nlm.nih.gov/36089781/

• Glucocorticoid Use and Increased Risk: The meta-analysis cited above specifically highlights that glucocorticoid use is associated with an increased risk of developing diabetes in SLE patients.

  • Source: Mendoza-Pinto, C., et al. (2024). Risk of diabetes mellitus in systemic lupus erythematosus: systematic review and meta-analysis. Rheumatology (Oxford, England).

  • Link: https://pubmed.ncbi.nlm.nih.gov/38552312/

• Antimalarial (Hydroxychloroquine) Protective Effect: This study shows that adherence to antimalarial therapy (a common lupus treatment) is associated with a reduced risk of Type 2 Diabetes.

  • Source: Salmasi, S., et al. (2020). Adherence to antimalarial therapy and risk of type 2 diabetes mellitus among patients with systemic lupus erythematosus: A population‐based study. Arthritis Care & Research.

  • Link: https://www.lupusresearch.org/common-lupus-medication-may-protect-against-type-2-diabetes/ (Summary of the study)

• Causal Relationship Between T1D and SLE: This Mendelian randomization study suggests a causal association between Type 1 Diabetes and SLE, pointing to shared genetic and immunological factors.

  • Source: Su, K., et al. (2023). A network causal relationship between type-1 diabetes mellitus, 25-hydroxyvitamin D level, and systemic lupus erythematosus: Mendelian randomization study. PLOS One.

  • Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC10191345/