During the Holidays, many of us will be celebrating the season with friends and families at parties and gatherings. During many of these events, delicious food and sweets will be in abundance. Many of us become less active in winter. Combine these factors, and it is no wonder weight gain can be an issue this time of year. Those who struggle with diabetes can be especially vulnerable.
Diabetes is an abnormality in blood sugar regulation and has effects on the entire body. Type 1 is a genetic condition that does not have a cure while type 2 is adult onset that can be fixed with proper nutrition and exercise. This month I wanted to highlight the effects of diabetes on the musculoskeletal system.
Diabetes impacts the musculoskeletal system by creating nerve damage (peripheral neuropathy), arterial disease and obesity. Here are a few of the common orthopedic conditions we see related to diabetes.
Osteoarthritis
Osteoarthritis (OA) is the ‘wear and tear’ type of arthritis that is created from overuse and overload. In the diabetic population, particularly type 2 diabetes, obesity is common and leads to loss of the articular cartilage (smooth layer that coats the ends of the bone). Pain from OA is dull, achy in nature, and worse with activity. Treatments include weight loss, anti-inflammatory medications, injections and surgery.
Osteoporosis
Type 1 diabetes can lead to low bone density. Low bone density can be graded as osteopenia when bone density is slightly below average, or osteoporosis when bone density is significantly below average. Low bone density can make patients susceptible to fractures. Vitamin D and calcium are important for bone health.
Frozen Shoulder
Frozen shoulder (adhesive capsulitis) is a condition where inflammation of the joint lining leads to progressive pain and loss of range of motion. It is divided into three phases: freezing phase, frozen phase, and thawing phase. During the freezing phase, pain is significant and range of motion begins to decrease. In the frozen phase, pain subsides put the shoulder remains with significant loss of motion. Eventually, the thawing phase will begin and the range of motion improves. The natural history of this condition is 2 years. The condition is more common in type 2 diabetics but the exact mechanism is unknown.
How do I prevent my diabetes from causing musculoskeletal problems?
Control Glucose Levels – work with your doctor to find the regimen that works best for you
Stay Active- exercise can decrease body weight, reducing the wear on the joints while also building bone mass
Proper nutrition and body weight- eating right will help maintain proper glucose levels, promote weight loss, and gives you the energy you need to exercise
Here’s to a healthy and happy Holiday Season!
-Ryan Morgan, MD