RESUMEN
Patients who are suffering of rheumatic diseases are at great risk for the development of diabetes mellitus; also diabetic patients who develop rheumatic disorders are liable to have fluctuating blood glucose. New onset diabetes, new onset hyperglycemia, uncontrolled pre-existing diabetes, difficulties in life style modifications, and acute complications of diabetes such as diabetic ketoacidosis and hypoglycemia; all of these present a major challenge in the management of patients with rheumatic diseases. There are multiple risk factors which contribute to this challenge. Some of the risk factors are related to the rheumatic disease itself, such as inflammatory cytokines, disease associated renal impairment, physical disability and gastroparesis. Drugs utilized for the treatment of rheumatic diseases [e.g., steroids, calcineurin inhibitors and hydroxychloroquine] impose a great risk in relation to diabetes. The role of non-pharmacological and pharmacological approach in the control of diabetes is essential and can deal well with the challenge