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Musculoskeletal complications in diabetes mellitus

Lesley D Hordon, MD
Section Editors
Ira N Targoff, MD
Jeremy M Shefner, MD, PhD
Deputy Editor
Paul L Romain, MD


A variety of musculoskeletal conditions have been associated with diabetes mellitus (table 1). These problems are important to recognize because they often respond to treatment, preventing pain and disability and improving quality of life. Specific arthropathies of the hand and shoulder are discussed in this review. The relationships of diabetes with osteoarthritis and gout have become more clear, and the data that bear on the associations are also briefly mentioned. Osteoarthritis and neck and shoulder disorders have a significant impact on the quality of life in people with type 2 diabetes [1].

Estimates of the prevalence of musculoskeletal problems in patients with diabetes mellitus vary depending upon the definitions used for the problems and the study population with diabetes, which can range from diabetics on an insurance database to primary care cohorts and patients with severe diabetes in a specialized referral setting.

There are several other musculoskeletal complications of diabetes mellitus which are discussed separately. These include limited joint mobility, neuropathic arthropathy (eg, Charcot joint), bone disease, and diabetic muscle infarction. (See "Limited joint mobility in diabetes mellitus" and "Diabetic neuropathic arthropathy" and "Bone disease in diabetes mellitus" and "Diabetic muscle infarction".)


Hand abnormalities are common in diabetic patients, reflecting pathologic changes in the microvasculature, connective tissue, and peripheral nerves. One study, for example, evaluated 100 diabetic patients selected randomly in an outpatient clinic. Hand abnormalities were observed in 50 patients, and more than one abnormality was found in 26 [2]. Furthermore, 25 of the 50 patients with hand syndromes were disabled to such an extent that surgery was recommended. Carpal tunnel syndrome, Dupuytren's contracture, flexor tenosynovitis, and limited joint mobility were each present in approximately 20 percent [2].

In a study of 200 patients with type 1 or type 2 diabetes and 100 controls, the prevalence of hand or shoulder disorders was higher in the diabetic patients than in controls and correlated with the duration, but not the type, of diabetes [3].

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Literature review current through: Nov 2017. | This topic last updated: Jun 08, 2017.
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