Being physically active helps people manage both diseases better by controlling blood sugar levels and reducing joint pain, according to the report in the May 9 issue of Morbidity and Mortality Weekly Report, a publication of the U.S. Centers for Disease Control and Prevention.

"The prevalence of arthritis is astoundingly high in people with diabetes," said Dr. John H. Klippel, president and CEO of the Arthritis Foundation. "Over half the people with diabetes have arthritis."

Although there appears to be a connection between arthritis and diabetes, the reason for it isn't known, Klippel said. A possible explanation is obesity, which is a risk factor for both osteoarthritis and diabetes, he speculated.

"In addition, those individuals who have diabetes and arthritis are less physically active," Klippel said. "We know that physical activity is critically important for the control of diabetes, both for the control of blood glucose and the prevention of complications."

Using data from the Behavioral Risk Factor Surveillance System, CDC researchers found 29.8 percent of people with both diseases were more likely to be inactive, compared with 21 percent of those who only have diabetes, 17.3 percent of those with arthritis alone, and 10.9 percent of those with neither condition.

For people who suffer from both diabetes and arthritis, arthritis appears to be a barrier to being physically active. But being physically active by doing aerobic exercise, strength training, walking, swimming or biking can benefit people with both diseases, according to the CDC.

"Public health efforts to control diabetes are going to have to begin to pay attention to this problem of arthritis, if we ever hope to get people physically active," Klippel said.

Klippel thinks the importance of physical activity needs to be emphasized. "Many people with arthritis don't exercise because it hurts them. But they have to understand that if they exercise, it will actually reduce their pain and prevents the disease from progressing," he said.

One of the keys to controlling diabetes is exercise, Klippel stressed.

"People with diabetes are going to have to pay a lot more attention to their arthritis if they hope to achieve better control of their diabetes," Klippel said. "People with arthritis are going to have to recognize that there is an association between diabetes and arthritis."

For people with arthritis and diabetes, the Diabetes Foundation recommends getting physically active by taking a walk at least three days a week.

The foundation recommends starting with a 10-minute walk, increasing it to 30 minutes over time. Before taking that walk, it's important to stretch your legs, lower back, chest and arms, Klippel said.

To keep yourself motivated, walk with a friend, the foundation suggests.

In addition, maintaining a healthy weight will place less stress on joints, particularly the knees. Also, being overweight can cause you to tire more quickly and give up on your exercise program.

More information

For more on arthritis, visit the Arthritis Foundation.

The bone loss described in a paper in the April 29 issue of Neurology was actually eight times higher than that experienced by premenopausal women who did not take any drugs for epilepsy.

"That suggests that if these women remain on this medication and have ongoing significant or accelerated bone loss that over time, they will be entering the peri-menopausal period with lower bone density and therefore a greater risk for low bone mineral density over time and therefore a higher risk of fractures," said study lead author Dr. Alison M. Pack, assistant professor of clinical neurology at Columbia University in New York City.

According to Dr. R. Eugene Ramsay, director of the International Center for Epilepsy at the University of Miami Miller School of Medicine, 90 percent of older people who have seizures are put on Dilantin, largely because it's inexpensive.

"It's particularly important, because the older population has the highest incidence of epilepsy. There are more new-onset seizures occurring there, and yet they are getting the cheapest and worst treatment," he said.

The findings are not entirely new, since previous research had already revealed an adverse effect on anti-epileptic drug treatment (Dilantin and other drugs) on bone and mineral metabolism. One previous study found that anti-seizure drugs had the same effect on the incidence of osteoporosis in older men as it did in older women, Ramsay said.

This study involved 93 premenopausal women (aged 18 to 40) with epilepsy, each of whom was taking either Dilantin (phenytoin), Tegretol (carbamazepine), Lamictal (lamotrigine) or Depakote (valproate).

The study was partially supported by GlaxoSmithKline, which makes Lamictal. Pack has also received funding from this and other pharmaceutical companies.

All participants took 1,000 milligrams of calcium a day and were physically active, both good strategies to maintain bone health.

After one year, women taking Dilantin lost 2.6 percent of their bone density in the femoral neck of the hip, while bone mineral density stayed about the same in the other three groups.

Bone mineral density stayed the same at the spine and the total hip.

The speed (one year) at which Dilantin affected bone health was surprising, said Dr. Steven V. Pacia, director of the division of neurology at Lenox Hill Hospital in New York City.

Women who need to take epilepsy drugs can either switch to a medication other than Dilantin, or they can up their intake of calcium, said Pack.

But according to Pacia, calcium supplementation may not be enough to counteract the bone-depleting effect of Dilantin.

"There may be a direct affect on bone absorption of calcium," Pacia said. "If the mechanism is damaged, the bone is not going to be able to take up calcium. An alternate drug that doesn't cause the same problem is preferable. In the rare cases we had to use [Dilantin], drugs like Fosamax and Boniva can be used to try to counteract the effect, and that does happen."

"We're just beginning to recognize that we need to look at the long-term health care issues of anti-convulsants," Ramsay said.

More information

The Epilepsy Foundation has more on this condition.

One study finds that long-term use of thiazolidinediones -- a family of diabetes drugs that includes blockbuster Avandia -- appears to be linked with an increased risk for bone fractures.

And a second study found that Fosamax, used to prevent fractures in women with osteoporosis, may be associated with a higher risk of atrial fibrillation, a type of abnormal heart rhythm.

Both studies were published in the April 28 issue of the Archives of Internal Medicine.

Avandia (rosiglitazone) and Actos (pioglitazone), both thiazolidinediones, now account for 21 percent of all oral anti-diabetic drugs prescribed in the United States. An estimated 3.5 million or more U.S. patients take Avandia, experts say.

But in 2007, Avandia and four other drugs from the same class were given a "black box" warning, cautioning users of an increased of heart problems.

The current study, led by Dr. Christian Meier of University Hospital Basel, Switzerland, looked at links between thiazolidinediones and fracture. It was designed to ascertain whether only women were affected and where fractures were most likely to occur. The research involved 1,020 men and women aged 30 to 89 who had sustained a fracture while taking Avandia, Actos, insulin or another anti-diabetic drug.

Compared to controls, individuals taking Avandia or Actos had more than double the risk of fractures, with the risk with Actos being slightly higher than with Avandia. Drug-associated fractures were particularly common at the wrist and hip. Both men and women were at risk, and the odds for fracture tended to rise with dose of drug taken.

The odds of sustaining a fracture were heightened in patients taking Avandia or Actos for 12 to 18 months and highest in those who were on the medication for two or more years.

Other anti-diabetic drugs did not show the same effect, but thiazolidinediones have a different mechanism of action (working at the cellular level) than other drugs for type 2 diabetes.

The findings echo some previous research which found an increased risk of fractures in women.

For now, the decision to use these particular diabetes drugs should be made on a case-by-case basis, experts said. Women who are postmenopausal and therefore at risk for fractures may want to be more careful, or take other measures to protect their bone health, they said.

"I think the benefit is more than the risk at this point. The benefit is huge in terms of glycemic control," said Dr. Spyros G.E. Mezitis, endocrinology consultant and clinical investigator at Lenox Hill Hospital in New York City.

"It remains to be seen if the way we practice medicine is going to change. These are important analyses, but we need further evidence," Mezitis added.

Nancy Pekarek, a spokeswoman for Avandia manufacturer GlaxoSmithKline, noted, "We do have fractures on our label and, in fact, when we saw data from the ADOPT (a previous, long-term trial), we issued a 'dear doctor' letter."

"The fractures have been observed, and we have made physicians aware of that so they can be watching for their patients and choose which drug is appropriate," Pekarek said. Unlike this trial, the fractures seen in ADOPT were more likely to be in the upper arm, hand or foot as opposed to hip and spine.

The Fosamax study, led by Dr. Susan Heckbert of the University of Washington and Group Health, Seattle, looked at 719 women with confirmed atrial fibrillation in a "real world" setting, versus 966 controls (without atrial fibrillation).

The study found that 6.5 percent of women who had used Fosamax had atrial fibrillation compared to 4.1 percent of controls. Based on these findings, the researchers estimated that 3 percent of new cases of atrial fibrillation in this group of women might be attributable to the use of Fosamax.

Again, the authors cautioned, risks and benefits should be carefully weighed when prescribing the drug.

Other studies have also reported atrial fibrillation as a side effect of bisphosphonates, the class of drugs that includes Fosamax.

Ronald Rogers, a spokesman for Fosamax manufacturer Merck & Co. Inc., called the Fosamax-fibrillation association an "old issue." He also pointed to an article published earlier this year in the British Medical Journal that found no such association.

Rogers also pointed out that the current study is an observational one and therefore subject to limitations not seen in a previous randomized trial. That trial saw an increase in the incidence of "serious" atrial fibrillation among Fosamax patients, he said, but it did not reach a statistically significant difference.

More information

There's more on type 2 diabetes at the American Diabetes Association.

Chemists analyzing extracts from a Chinese medicinal ant, Polyrhacis lamellidens, found two polyketides, potent natural products that other studies have deemed as promising treatments for arthritis, bacterial infections and many other diseases. Polyketides are also found in plants, fungi and bacteria.

The findings, published in the April 25 issue of American Chemical Society's Journal of Natural Products, support Chinese folk medicine's practice of using ants as a health food or drink ingredient to treat conditions such as joint pain or hepatitis.

Researchers have long suspected this is due to substances in the ants, but the exact chemicals responsible for the medicinal effects have largely been unknown.

More information

The National Center for Complementary and Alternative Medicine has more about alternative treatments for rheumatoid arthritis.

The findings, published April 4 in the open-access journal PLoS Genetics, may help define some of biological pathways that cause psoriasis and aid in the development of treatments that target these specific avenues.

"Common diseases like psoriasis are incredibly complex at the genetic level," lead investigator Anne Bowcock, a professor of genetics at the Washington University School of Medicine in St. Louis, said in a prepared statement. "Our research shows that small but common DNA differences are important in the development of psoriasis. Although each variation makes only a small contribution to the disease, patients usually have a number of different genetic variations that increases their risk of psoriasis and psoriatic arthritis."

Psoriasis, in which the body's immune cells mistakenly attack the skin, is characterized by red, scaly patches that can be itchy, painful or both. The autoimmune disease affects an estimated 7 million Americans. Up to 30 percent of sufferers may also develop psoriatic arthritis, an often excruciatingly painful and debilitating condition.

For the study, the researchers looked at common variations in the DNA genome called single nucleotide polymorphisms (SNPs). About 10 million SNPs affect the genome to make each individual unique. Some SNPs also affects a person's predisposition to disease or good health.

The investigators scanned more than 300,000 SNPs in the genomes of 223 psoriasis patients, including 91 who had psoriatic arthritis, and compared them to those found in 519 healthy control patients.

Researchers found seven unique DNA variations linked to psoriasis. Several found on chromosome 4 were strongly linked to psoriatic arthritis. These same variations were also associated with psoriasis and had been previously linked to type 1 diabetes, rheumatoid arthritis, Grave's disease (caused by an overactive thyroid gland) and celiac disease (caused by the inability to digest gluten).

A larger genome-wide association study of psoriasis patients is under way, and Bowcock said she expects it to find more genetic variations linked to the condition.

More information

The U.S. National Library of Medicine has more about psoriasis.