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Diabetes May Raise Risk of Arthritis and Osteoporosis, Study Finds
The good news is exercise can offer positive effects on blood sugar levels and musculoskeletal pain.
By Don Rauf
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October 4, 2019
Several musculoskeletal disorders have been linked to diabetes in the past. Now a large new study, presented October 3, 2019, at the European Association for the Study of Diabetes (EASD) Annual Meeting in Berlin, Germany, has found that diabetes is tied to a greater likelihood of having osteoarthritis, rheumatoid arthritis, and osteoporosis.
“The take-home message is that the odds of having pains from the skeletal system and a rheumatic disease are elevated if you have diabetes,” says study author Stig Molsted, PhD, senior researcher from Nordsjaellands University Hospital in Hillerød, Denmark.
A study published in November 2015 in the journal BMC Musculoskeletal Disorders showed that people with diabetes had more musculoskeletal pain, and visited the doctor for this pain, more than people without diabetes over a 10-year period.
For the new study, Dr. Molsted and his colleagues reviewed self-reported health data on 109,200 individuals in Denmark. Of those, 9,238 (or about 8.5 percent) had diabetes. Because the investigation included only people over 40, their diabetes was most likely type 2 diabetes, said the study authors.
Their analysis showed that compared with people without diabetes, those with diabetes were 70 percent more likely to have rheumatoid arthritis, 33 percent more likely to suffer from osteoarthritis, and 29 percent more likely to have osteoporosis.
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Physical Activity Helps Reduce Pain in People With Diabetes
The study authors stressed that exercise appeared to benefit people with diabetes. Those who were more physically active reduced their chance of having back pain and shoulder or neck pain.
“If patients have diabetes, they may not only have positive effects of exercise training on blood glucose levels, but also on pains from the muscular skeletal system,” says Molsted.
He adds that exercise may even have a positive effect on patients with arthritis who have trouble moving. “If the patients with diabetes and a rheumatic disease find it difficult to perform exercise, it may be relevant to use medication to decrease the pains in order to be able to perform the exercise,” says Molsted. “The positive effects of exercise may exceed the side effects of the medication.”
Someone like this may have to start with some low-impact activity, like walking, cycling, or exercise in water, he says. Then after a period of training, they may have reduced the pain and be able to perform other types of exercise.
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Why Diabetes Leads to Musculoskeletal Pain
Gerald Bernstein, MD, program coordinator with Friedman Diabetes Institute at Lenox Hill Hospital in New York City, was not surprised by the study results.
“Uncontrolled diabetes with chronically elevated blood glucose is a destructive disorder, which can result in early aging of tissues,” says Dr. Bernstein, who was not involved with the study. “Osteoarthritis is a degenerative disease, and it is highly likely poor [diabetes] control would result in early presentation.”
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Also called “wear-and-tear” arthritis, osteoarthritis is the most common type of arthritis, affecting about 27 million Americans, according to the Arthritis Foundation. The disease damages the slippery tissue that covers the ends of bones in a joint. Bones then rub together, resulting in pain and stiffness. Most who get the condition are middle-aged or older; it tends to affect the knees, the lower back, and the neck, as well as the small joints of the fingers, and the bases of the thumb and big toe. Arthritis also can develop in the weight-bearing hip joints.
Rheumatoid arthritis is a chronic autoimmune disease that triggers the body’s immune system so it mistakenly attacks the joints. The Arthritis Foundation explains that inflammation caused by the disease causes tissue lining joints to thicken, which then results in swelling and pain.
Osteoporosis, which means “porous bone,” occurs when the body loses too much bone, makes too little bone, or both. In this weakened state, bones are more likely to break.
The authors noted that the strong connection between rheumatoid arthritis and diabetes is likely to be the result of chronic inflammation or steroid treatment that can lead to type 2 diabetes.
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Although ties between these musculoskeletal disorders and diabetes are apparent, Molsted says it’s difficult to draw conclusions about cause and effect. The authors also pointed out that the study is limited because it is based on self-reported data.
“Our next step is to test the effects of exercise training on musculoskeletal pain in patients with diabetes,” says Molsted.
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