Do Tumor Necrosis Factor (TNF) Inhibitors Improve the Glycemic Control in Patients with Rheumatoid Arthritis and Concomitant Diabetes Mellitus?

Inflammation and insulin resistance are closely linked to each other. Inflammatory rheumatic diseases including rheumatoid arthritis (RA) are associated with increased insulin resistance and reduced insulin sensitivity by virtue of proinflammatory cytokines, mainly tumor necrosis factor alpha (TNF-α). TNF inhibitors have been shown to improve the insulin sensitivity and reduce the risk of incident diabetes in patients with RA. We hypothesize that TNF inhibitors may improve the glycemic control in patients with concomitant RA and diabetes mellitus.