Improvement in polymyalgia rheumatica associated with improved control of diabetes

A three-case series suggests that tighter glycemic control might allow some patients with type 2 diabetes to avoid glucocorticoid treatment for polymyalgia rheumatica.

Patients with polymyalgia rheumatic and type 2 diabetes had improvement in rheumatic symptoms and laboratory measures after achieving good glycemic control, according to a series of three cases.

The case series, published as a letter by Annals of Internal Medicine on Sept. 15, described three patients whose polymyalgia rheumatica improved rapidly without glucocorticoid administration or an increase in glucocorticoid dosage after they achieved good glycemic control. “These findings were unexpected and are remarkable,” the authors said. They offered some speculations about possible mechanisms for the findings and recommended a randomized controlled trial of intensified glucose treatment, possibly with a meglitinide, in patients with type 2 diabetes and polymyalgia rheumatica.