The management of diabetes mellitus with hyperuricemia

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Purpose: Serum uric acid (SUA) is a strong and independent risk factor for diabetes mellitus (DM), and hyperuricemia incidence increases in DM patients compared with unaffected counterparts. This article summarizes recently published evidence on how to better manage medications for diabetic patients with chronic hyperuricemia.
Findings: Researchers have found that serum uric acid is an independent predictor for the incidence of type 2 diabetes. Both insulin resistance (IR) and β-cell failure are regarded as two key events in type 2 diabetes development, and high uric acid levels was positively associated with IR. Elevated serum uric acid levels may enhance the development of chronic diabetic complications including macro and microvascular dysfunction. The importance of UA as a risk factor requires re-evaluation. It makes sense to eat a reasonably balanced diet for diabetic patients with hyperuricemia. The best philosophy is to modify diet to low-sugar, low-purine and high-fibre foods. The clinical use of urate lowering therapy on DM should not be ignored. The selection of agents is therefore based on lowering SUA, blood glucose, blood pressure, anticoagulation, etc. When treatment goals are not achieved in hyperglycemia patients, combination with a urate lowering drug might be very useful.
Conclusion: Serum uric acid is an independent risk factor for incident diabetes. Therefore, the management of hyperuricemia in DM patients demands more attention, particularly in regards to specific features in diagnosis and therapeutic approach.