Gout: An Overlooked Disease in Patients With Diabetes? A Danish Prospective Cohort Study With 2 Years of Follow-Up

Diabetes affects approximately 6% of the population, with 20% developing foot ulcers. Gout affects about 3% of the population, but <40% receive sufficient urate-lowering therapy to prevent or dissolve urate crystal (tophi) deposition in the feet, which can ulcerate and become infected. Among patients with diabetes, 20% also have gout. This study aimed to assess adherence to recommended gout treatment in patients with diabetes and to compare usual care with initial care provided by a nurse-led gout care program. In patients with diabetes, gout is frequently undertreated, particularly when not initially managed in a nurse-led gout care program. Key Points · Most patients with gout receive suboptimal urate-lowering treatment to prevent or dissolve urate deposits (tophi). · In this study, among patients with diabetes and gout, 67% maintained urate levels to prevent tophi. However, 50% of patients with diabetes presented with tophi, and after 2 years, only 45% achieved the lower urate level necessary to dissolve tophi. · Gout in patients with diabetes is often inadequately managed, leading to the persistence of tophi, which may mimic foot ulcers.