Psoriasis and Type 2 Diabetes: Review Highlights Bidirectional Inflammatory Link and Need for Integrated Management

 A systematic review, published in Minerva Medica, has reinforced the strong bidirectional relationship between psoriasis and type 2 diabetes mellitus, emphasizing the importance of multidisciplinary strategies that address both dermatologic and metabolic components of care. The findings highlight the role of shared inflammatory pathways and the potential for integrated treatment approaches to improve patient outcomes.

“Evidence consistently showed an increased prevalence of type 2 diabetes among psoriasis patients,” the authors reported, underscoring a well-established epidemiologic link. The review analyzed observational studies and clinical trials across all age groups and genders, with a focus on inflammatory mechanisms and therapeutic interventions relevant to both conditions. 

Central to the pathophysiologic connection is the IL-23/IL-17 axis, which contributes to chronic inflammation in psoriasis and simultaneously drives insulin resistance. “The IL-23/IL-17 axis plays a critical role in the inflammation driving both psoriasis and insulin resistance,” the study stated. Inflammatory cytokines not only contribute to psoriatic lesions but also promote components of metabolic syndrome, such as obesity. In turn, obesity and insulin resistance exacerbate systemic inflammation, forming a feedback loop that perpetuates both diseases. 

This cycle has critical implications for long-term disease progression and comorbidity management. According to the authors, “Insulin resistance and obesity amplify systemic inflammation, creating a vicious cycle in psoriasis patients.”

 The review also identified promising approaches for simultaneous management. Integrated therapeutic strategies—combining targeted pharmacologic treatments like biologics with lifestyle modifications such as diet and exercise—showed benefit in addressing both cutaneous and metabolic disease features. These combined strategies offer dual benefits: controlling skin symptoms while improving glycemic control and metabolic health.

“Integrated treatment approaches, combining targeted pharmacologic therapies with lifestyle modifications, demonstrated potential in managing both conditions effectively,” the authors wrote. The findings strongly support a collaborative care model, involving dermatologists, endocrinologists, and primary care providers.

For practicing dermatologists, the study reinforces the importance of screening patients with psoriasis for metabolic risk factors and working in partnership with other specialties. The authors concluded, “Integrated therapeutic strategies that include lifestyle changes and targeted drug interventions show promise in improving outcomes for individuals affected by both conditions.”

The review calls attention to the clinical need for proactive, cross-disciplinary care in managing the systemic burden of psoriasis, especially in patients with or at risk for type 2 diabetes. 

Reference
De Luca DA, Papara C, Hawro T, Thaçi D. Psoriasis and diabetes: a review of the pathophysiological and therapeutic interconnections. Minerva Med. 2025;116(3):195-222. doi:10.23736/S0026-4806.24.09570-3