Monday, May 20, 2013

Type 2 Diabetes and Musculoskeletal Disease: Is There a Connection Between the Two?


Type 2 diabetes is associated with numerous chronic diseases. Musculoskeletal disease or disease of the muscles and their associated ligaments, and other connective tissue, is one of the most common problems among people with diabetes. With the ever-increasing number of diabetics suffering from joint pains, one question is left unanswered: is there a connection between Type 2 diabetes and musculoskeletal disease or do these two disease entities only happen together by chance?

According to John Hopkins Point of Care Information Technology (POC-IT) Center, a vast number of diabetics have musculoskeletal disorders. The most affected joints include the hands and feet and the shoulders. And with the increasing duration of uncontrolled Type 2 diabetes, the tendency for the development of musculoskeletal disease increases as well.

The most common forms of musculoskeletal disease in diabetics include:

1. Carpal tunnel syndrome is most often characterized by the limited movement of the wrist brought about by the entrapment of an important nerve in between the small bones of the wrist. More than twenty percent of diabetics have carpal tunnel syndrome.

2. Dupuytren's contracture is characterized by the stiffness of the joints of the hands due to inflammation involving the joints. Flexion of the little finger, the ring finger, and frequently the middle fingers, renders them more or less useless. This condition always starts in one hand, but eventually both become deformed symmetrically. According to John Hopkins POC-IT Center, almost forty percent of people with Type 2 diabetes also suffer from Dupuytren's contracture.

3. Flexor tenosynovitis... "trigger" finger is the most common symptom of flexor tenosynovitis. It is caused by nodal formations over the tendons that cause flexion of the fingers and thumbs. Trigger finger will limit finger movement... you will find when you try to straighten your finger, the finger will lock or catch before straightening out. This joint problem occurs in twenty percent of people with diabetes regardless of their blood sugar control.

4. Osteoarthritis... according to John Hopkins POC-IT Center, osteoarthritis is believed to be associated with diabetes because of obesity. People who are suffering from chronic osteoarthritis tend to develop Type 2 diabetes because of the habitual usage of glucocorticoids, a steroidal anti-inflammatory medication. In a study published by Hippokratia in October 2007, it was shown the cause of osteoarthritis in diabetes is not merely due to obesity. The researchers of this study point out even non-weight bearing joints of people with diabetes also become involved in this musculoskeletal problem which only shows the development of osteoarthritis and diabetes may have a common pathophysiologic mechanism which is still unclear up to this time.

Osteoarthritis is the most common type of connective tissue disease in the US. It can begin as early as the second decade of life and peaks in the fifth and sixth decades. By age 70, more than 80% of people have some form of bone degeneration.

Type 2 diabetes and musculoskeletal disease may be seen together because of coincidence. They may also be due to a common pathophysiological mechanism that is yet to be discovered. However, for most people suffering from the pains brought about by musculoskeletal disease, one thing remains important: the treatment that can permanently ease their joint pains whether they have Type 2 diabetes or not.

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