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Curr Opin Rheumatol (2015) 27(2):20411

10.1152/physiol.00003.2018 Physiology

22 However, the fact that the magnitude and speed of hemoglobin A1c reduction with treatment were identified as risk factors for progression suggests it could be another example of the well-established early worsening phenomenon first observed in type 1 diabetic patients intensively treated with insulin in the Oslo Study, Kroc Collaborative Study and Diabetes Control and Complications Trial

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Thus, purine catabolism appears to be a homeostatic response of mitochondria to oxidant stress and may protect against progressive mitochondrial dysfunction in certain disease states (Kristal et al., 1999)

Youre especially vulnerable if you drink regularly or take high doses