Type 2 Gout and diabetes

[Mdub]

I am a 53 y/o male with T2 and gout. First question, anybody else dealing with these conditions? Second, due to the diet constraints of both, how are you managing both?

 

[KennyA]

Hi and welcome to the forums. I also have (had) the gout and T2 problem. Gout in both big toe joints. My experience has been that my gout vanished since I got my blood glucose levels back to normal. Before that (ie 2019 and back) it was managed by using naproxen and codeine.

I have found zero association between the usual suspects for gout (purines from meat, wine, shellfish, alcohol etc) and what was happening. It's therefore not been a problem to manage diet, as no management was needed. I eat around 20g carb/day, lots of meat and fats, a fair amount of alcohol, shellfish, that sort of thing.

I suspect that what was happening with me was that, because the T2 affected my kidney functions, I wasn't urinating very often. I was therefore not getting rid of uric acid and was getting build-up. Now that my BGs have neen normal for getting on three years, and my kidneys are functioning properly, I'm not getting any uric acid build-up, no crystallising and therefore no inflammation or pain.

I found this link helpful:

Gout

Gout is a form of arthritis, causing intensely painful, red, hot and swollen joints (often the big toe). Learn about the causes, symptoms and treatments.

www.versusarthritis.org

Best of luck. Hope this helps. Gout is awful to live with.

 

[Resurgam]

I had gout a couple of times but only when eating a high carb diet. It was quite memorable. I discovered that eating cherries, (small amounts twice a day) helped reduce the swelling.
Since going back to the meat, fish etc. I've not had any trouble of that sort.

 

[Grant_Vicat]

Hi and welcome to the forums. I also have (had) the gout and T2 problem. Gout in both big toe joints. My experience has been that my gout vanished since I got my blood glucose levels back to normal. Before that (ie 2019 and back) it was managed by using naproxen and codeine.

I have found zero association between the usual suspects for gout (purines from meat, wine, shellfish, alcohol etc) and what was happening. It's therefore not been a problem to manage diet, as no management was needed. I eat around 20g carb/day, lots of meat and fats, a fair amount of alcohol, shellfish, that sort of thing.

I suspect that what was happening with me was that, because the T2 affected my kidney functions, I wasn't urinating very often. I was therefore not getting rid of uric acid and was getting build-up. Now that my BGs have neen normal for getting on three years, and my kidneys are functioning properly, I'm not getting any uric acid build-up, no crystallising and therefore no inflammation or pain.

I found this link helpful:

Gout

Gout is a form of arthritis, causing intensely painful, red, hot and swollen joints (often the big toe). Learn about the causes, symptoms and treatments.

www.versusarthritis.org

Best of luck. Hope this helps. Gout is awful to live with.

This makes complete sense.When I had CKD approaching level 4, I got regular attacks of gout (and cellulitis), often in the feet, but even in the sternum. The worst attack was in the feet, elbow and left hand at the same time. After I had received a replacement kidney, I never experienced gout again. I have been drinking alcohol for 51 years and even when I was a student didi not experience the "burning knife pain". Carbohydrates have been at 240g daily since 1966! So clearly experiences vary.

 

[Mdub]

First off, thanks so much for responding! It's interesting that it appears Kidney function is at the center of the problem for some, that isn't something I have heard before. Per recent bloodwork, my Kidneys read fine.

More backstory: I just recently got on medication for T2 (Metformin 500mg/day, Jardiance 10mg) and drastically changed the diet to a predominately protein-based plan (probably close to Keto). Almost immediately the gout flare-ups started coming, back to back. My GP says the diet is the likely culprit, I was on a fairly low dose of Alopurinol and close to "normal" carb/protein/fat diet before I got on the T2 Meds (my A1c was 11.3) and that kept the gout at bay for almost a year. Recently, I upped the Alopurinol to max at his advisement and I am taking Colchicine for the flare-ups. My point, I need to reign the gout in because I DO NOT want all these meds in my system all the time. Again, really appreciate the feedback, it's HUGE.

 

[CaminoTurtle]

Recently, I upped the Alopurinol to max at his advisement and I am taking Colchicine for the flare-ups. My point, I need to reign the gout in because I DO NOT want all these meds in my system all the time. Again, really appreciate the feedback, it's HUGE.

Hi @Mdub, I'm just wondering how you are doing now with the gout and T2? I'm at the beginning of th journey, having just started last week on allopurinol and being pre-diabetic.