Epidemiology of Diabetes Mellitus in Patients With Psoriatic Arthritis: Current Evidence

Diabetes mellitus (DM) is a common comorbidity of psoriatic arthritis (PsA); however, its global prevalence and the impact of treatment exposure remain unclear. This study aimed to assess the global prevalence of DM in patients with PsA using different subgroup analyses.

A systematic search of PubMed, Embase, the Cochrane Library and the Web of Science was performed from inception until February 2025 for observational studies reporting the prevalence or incidence of DM in PsA patients. Random-effects models were applied to pool estimates, and subgroup, meta-regression, and sensitivity analyses were conducted to explore heterogeneity. Publication bias was evaluated using the Egger's test and the trim-and-fill method.

Sixty-three studies, including 293,582 patients with PsA, were analysed. Patients with PsA included in this study were divided into treatment-disclosed and non-treatment-disclosed groups. DM overall prevalence in patients with PsA was 13.84% in the non-treatment-disclosed population and 13.50% in the treatment-disclosed cohort. Geographically, the comorbidity prevalence rates were higher in South America (37.98%) and Asia (16.76%) than in Europe (12.81%) and North America (12.38%) in the non-treatment-disclosed population. In the treatment-disclosed population, prevalence was also highest in South America (28.13%), followed by Asia (18.30%). Meta-regression analysis identified age, type of DM, region, and study design as contributors to heterogeneity. Evidence of small-study effects was detected in the T2DM subgroup and cohorts receiving systemic therapy plus biologics.

Subgroup analysis shows that the prevalence of DM is associated with the type of study and the region in which the patients were located. These findings support routine metabolic screening for PsA and highlight the need for longitudinal studies to track disease activity, treatment patterns, and metabolic outcomes.