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Understanding Multimorbidity: The Link between Type 2 Diabetes and Osteoarthritis

Featured Publication, ITG,

The coexistence of multiple chronic diseases in a single individual, defined as multimorbidity, poses a significant challenge in healthcare as the global population ages. In a collaborative effort, researchers investigated the link between type 2 diabetes and osteoarthritis. By integrating genetic data and functional information, they identified genes associated with this comorbidity, offering insights into underlying biological processes and potential opportunities for drug repurposing.

Multimorbidity refers to the simultaneous presence of multiple chronic diseases in a single individual. As life expectancy continues to rise worldwide, multimorbidity is becoming a significant challenge in the healthcare system. Ph.D. candidate Ana Luiza Arruda and her colleagues from the Institute of Translational Genomics led by Prof. Eleftheria Zeggini at Helmholtz Munich collaborated with researchers from the University of Bristol and the University of Manchester to investigate the association between type 2 diabetes (affecting over 430 million people) and osteoarthritis (affecting over 520 million people) (Vos et al., The Lancet 2020). The comorbidity between these two complex diseases represents one of the most common multimorbidity patterns worldwide, a combination of cardiometabolic and osteoarticular diseases. Zeggini’s team has been centrally involved in genomics initiatives around each of the two diseases individually.

Arruda and the team developed and applied an analytical framework that integrates genotype data, omics and functional information from disease-relevant tissues to identify a list of high-confidence effector genes associated with the comorbidity of type 2 diabetes and osteoarthritis. Thereby, researchers successfully demonstrated a genetic overlap between the two diseases. Their findings offer insights into the biological processes underlying the comorbidity and highlight potential opportunities for drug repurposing and new targets. The approach presented in their publication is applicable to any combination of comorbid diseases and can help improve our understanding of the co-occurrence of these chronic conditions.

“We wished to move the shared genetic risk findings forward into translation opportunities. Given that two-thirds of FDA-approved drugs are supported by genetic evidence, we are excited about the impact this work can have in improving the lives of patients suffering from osteoarthritis and type 2 diabetes,” emphasizes Ana Luiza Arruda, first author of the study. Their genomic findings will increasingly gain importance as the global population continues to age, thereby amplifying the challenges faced by the healthcare system in managing the co-occurrence of chronic conditions.


About the scientists

Eleftheria Zeggini, Director at the Institute of Translational Genomics at Helmholtz Munich and Professor for Translational Genomic at the TUM School of Medicine at the Technical University Munich (TUM) and at the University Hospital rechts der Isar

Ana Luiza Arruda, PhD-Student at the Institute of Translational Genomics at Helmholtz Munich

Original publication

Arruda et al. (2023): Genetic underpinning of the comorbidity between type 2 diabetes and osteoarthritis. American Journal of Human Genetics. DOI:

More information about diabetes 

Further information about diabetes mellitus can be found at - the national diabetes information portal. is a joint service of Helmholtz Munich, the German Diabetes Center (DDZ) and the German Center for Diabetes Research (DZD).  

In the sections Preventing diabetes, Living with diabetes and Information for diabetes professionals, you will find up-to-date, neutral and scientifically proven information on all forms of diabetes mellitus as well as on the prevention of diabetes. is also available in EnglishTurkishRussianPolish.

Portrait Ana Arruda

Ana Luiza Arruda