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Orthopedic Issues and Diabetes: Understanding the Connection

December 13, 2023

All the systems in the body work together for proper function and health as a whole. This also means that when one system is facing problems, other systems are often also affected. 

In this month’s blog we’ll discuss diabetes, a disease occurring in the endocrine system, and if not taken care of how it can lead to issues in the skeletal and neurological systems. 

What is Diabetes? 



Most of the food we eat is broken down into sugar, or glucose, and is released into the bloodstream. When our blood sugar goes up, the pancreas is signaled to release insulin which is the key to letting the blood sugar into the cells for use as energy. 

Individuals with diabetes’s bodies don’t make enough insulin or can’t utilize it as well as they should. When this happens, too much blood sugar stays in the bloodstream and over time can cause serious health problems including heart disease, vision loss, and kidney disease. 

There are two main types of diabetes. Type I is an autoimmune condition and primarily thought to be genetic, often showing up in childhood. The pancreas in individuals with Type I diabetes does not produce insulin of its own, making it necessary for individuals to monitor their blood sugar and take insulin injections when necessary. 

Type II diabetes is an acquired condition that occurs when blood sugar levels are consistently high, causing the body to produce less insulin. This often occurs in middle to late adulthood and in most cases can be attributed to genetics and lifestyle including obesity, a sedentary lifestyle, and poor diet. For Type II diabetics, the body has an insufficient amount or response to insulin and is managed with lifestyle changes, medication, or insulin injections. 

How does diabetes affect orthopedics?

When not managed, diabetes can lead to inflammation, nerve damage, and joint pain. It can also either accelerate or inhibit bone development and healing due to high insulin levels promoting too much bone growth, or lead to weakened bones if levels are too low.  

Potential Issues

  • Osteoarthritis - The degeneration of cartilage between the main joints in the body. 

  • Osteoporosis - Weakening of the bones to a fragile, porous state to resemble the structure of a sponge. 

  • Diffuse Idiopathic Skeletal Hyperostosis (DISH) - The hardening of the connective tissue, leading to pain, stiffness, and immobility especially in the spine. 

  • Risk of Fractures - Osteoporosis, neuropathy, and hardened ligaments increase the potential for falls, which then increases the chance of fractures. 

  • Joint Issues - The Arthritis Foundation notes that people with diabetes are two times as likely to develop arthritis than those without diabetes. 

  • Frozen Shoulder - Condition in which the bones, ligaments, and tendons of the shoulder joint become thick and hardened leading to restricted movement and pain. 

  • Charcot Joint - Damage to the nerves is the primary cause, wrestling in degeneration and inflammation of the joints, often affecting the feet. 

Impacts on Treatment Options 

When an individual has diabetes and an orthopedic condition, some patients will not respond as well to traditional treatment options and will have to look for more effective options. For example, nonsurgical treatments for a frozen shoulder will not be as effective as surgical intervention. When it comes to surgical treatments, those with controlled diabetes will also have better outcomes than those with uncontrolled diabetes. 


Managing Diabetes and Orthopedic Health


For those with diabetes, keeping your bones healthy starts with keeping diabetes under control. Focusing on a healthy lifestyle with choices that decrease inflammation is key. Prioritizing exercising regularly, obtaining and maintaining an ideal body weight, keeping good glycemic control, and minimizing tobacco and alcohol use will all help with this goal. Monitoring blood sugar and seeing a primary care doctor will also be beneficial in ensuring you catch issues early. 

The importance of keeping diabetes under control is serious when it comes to short-term and long-term joint and bone issues. With the proper management, you will be able to minimize and even stop any connected health issues!