Rheumatic conditions in patients with diabetes mellitus

  • 1421 Accesses

  • 17 Citations


Diabetes mellitus (DM) is a chronic systemic disease with a wide range of complications, including complications in the musculoskeletal system. DM is a common disease in nearly all countries and continues to increase in numbers and significance. Approximately 90 % of patients have type 2 DM which is caused by resistance to insulin. Type 1 DM results from an absolute deficiency of insulin due to an autoimmune destruction of insulin-producing beta cells within the pancreas. Diabetic patients suffer from diverse rheumatic conditions that affect their life quality. This article reviews the rheumatic conditions that are associated with DM and the pathophysiologic relationships that might link these conditions; it also summarizes recent advances in the field of diabetes and rheumatic conditions. The rheumatic conditions that are discussed in this review include limited joint mobility, Dupuytren’s contracture, flexor tenosynovitis, carpal tunnel syndrome, adhesive capsulitis, diffuse idiopathic skeletal hyperostosis, neuropathic osteoarthropathy, diabetic muscle infarction, crystal induced arthritis, osteoarthritis, and reflex sympathetic dystrophy.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 99

This is the net price. Taxes to be calculated in checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4


  1. 1.

    Pal B, Anderson J, Dick WC, Griffiths ID (1986) Limitation of joint mobility and shoulder capsulitis in insulin- and non-insulin-dependent diabetes mellitus. Br J Rheumatol 25(2):147–151

  2. 2.

    Rosenbloom AL, Silverstein JH, Lezotte DC, Richardson K, Mccallum M (1981) Limited joint mobility in childhood diabetes mellitus indicates increased risk for microvascular disease. N Engl J Med 305(4):191–194

  3. 3.

    Fitzcharles MA, Duby S, Waddell RW, Banks E, Karsh J (1984) Limitation of joint mobility (cheiroarthropathy) in adult noninsulin-dependent diabetic patients. Ann Rheum Dis 43(2):251–254

  4. 4.

    Starkman HS, Gleason RE, Rand LI, Miller DE, Soeldner JS (1986) Limited joint mobility (LJM) of the hand in patients with diabetes mellitus: relation to chronic complications. Ann Rheum Dis 45(2):130–135

  5. 5.

    Arkkila PE, Kantola IM, Viikari JS, Ronnemaa T, Vahatalo MA (1996) Limited joint mobility is associated with the presence but does not predict the development of microvascular complications in type 1 diabetes. Diabet Med 13(9):828–833

  6. 6.

    Aljahlan M, Lee KC, Toth E (1999) Limited joint mobility in diabetes. Postgrad Med 105(2):99–101, 105–106

  7. 7.

    Wyatt LH, Ferrance RJ (2006) The musculoskeletal effects of diabetes mellitus. J Can Chiropr Assoc 50(1):43–50

  8. 8.

    Ardic F, Soyupek F, Kahraman Y, Yorgancioglu R (2003) The musculoskeletal complications seen in type II diabetics: predominance of hand involvement. Clin Rheumatol 22(3):229–233

  9. 9.

    Cagliero E, Apruzzese W, Perlmutter GS, Nathan DM (2002) Musculoskeletal disorders of the hand and shoulder in patients with diabetes mellitus. Am J Med 112(6):487–490

  10. 10.

    Carson J, Clarke C (1993) Dupuytren's contracture in pensioners at the Royal Hospital Chelsea. J R Coll Physicians Lond 27(1):25–27

  11. 11.

    Lennox IA, Murali SR, Porter R (1993) A study of the repeatability of the diagnosis of Dupuytren's contracture and its prevalence in the Grampian region. J Hand Surg Br 18(2):258–261

  12. 12.

    Childs SG (2005) Dupuytren's disease. Orthop Nurs 24(2):160–163, quiz 164–165

  13. 13.

    Hurst LC, Badalamente MA, Hentz VR et al (2009) Injectable collagenase clostridium histolyticum for Dupuytren's contracture. N Engl J Med 361(10):968–979

  14. 14.

    Leden I, Schersten B, Svensson B, Svensson M (1983) Locomotor system disorders in diabetes mellitus. Increased prevalence of palmar flexortenosynovitis. Scand J Rheumatol 12(3):260–262

  15. 15.

    Yosipovitch G, Yosipovitch Z, Karp M, Mukamel M (1990) Trigger finger in young patients with insulin dependent diabetes. J Rheumatol 17(7):951–952

  16. 16.

    Lebiedz-Odrobina D, Kay J (2010) Rheumatic manifestations of diabetes mellitus. Rheum Dis Clin North Am 36(4):681–699

  17. 17.

    Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I (1999) Prevalence of carpal tunnel syndrome in a general population. JAMA 282(2):153–158

  18. 18.

    Perkins BA, Olaleye D, Bril V (2002) Carpal tunnel syndrome in patients with diabetic polyneuropathy. Diabetes Care 25(3):565–569

  19. 19.

    Kennedy JM, Zochodne DW (2005) Impaired peripheral nerve regeneration in diabetes mellitus. J Peripher Nerv Syst 10(2):144–157

  20. 20.

    Amirfeyz R, Gozzard C, Leslie IJ (2005) Hand elevation test for assessment of carpal tunnel syndrome. J Hand Surg Br 30(4):361–364

  21. 21.

    Ahn DS (2001) Hand elevation: a new test for carpal tunnel syndrome. Ann Plast Surg 46(2):120–124

  22. 22.

    Ibrahim I, Khan WS, Goddard N, Smitham P (2012) Carpal tunnel syndrome: a review of the recent literature. Open Orthop J 6:69–76

  23. 23.

    Scutt N, Rolf CG, Scutt A (2006) Glucocorticoids inhibit tenocyte proliferation and Tendon progenitor cell recruitment. J Orthop Res 24(2):173–182

  24. 24.

    Makepeace A, Davis WA, Bruce DG, Davis TM (2008) Incidence and determinants of carpal tunnel decompression surgery in type 2 diabetes: the Fremantle Diabetes Study. Diabetes Care 31(3):498–500

  25. 25.

    Manske RC, Prohaska D (2008) Diagnosis and management of adhesive capsulitis. Curr Rev Musculoskelet Med 1(3–4):180–189

  26. 26.

    Tighe CB, Oakley WS Jr (2008) The prevalence of a diabetic condition and adhesive capsulitis of the shoulder. South Med J 101(6):591–595

  27. 27.

    Griggs SM, Ahn A, Green A (2000) Idiopathic adhesive capsulitis. A prospective functional outcome study of nonoperative treatment. J Bone Joint Surg Am 82-A(10):1398–1407

  28. 28.

    Crispin JC, Alcocer-Varela J (2003) Rheumatologic manifestations of diabetes mellitus. Am J Med 114(9):753–757

  29. 29.

    Hsu JE, Anakwenze OA, Warrender WJ, Abboud JA (2011) Current review of adhesive capsulitis. J Shoulder Elbow Surg 20(3):502–514

  30. 30.

    Rogers LC, Frykberg RG, Armstrong DG et al (2011) The Charcot foot in diabetes. Diabetes Care 34(9):2123–2129

  31. 31.

    Boddenberg U (2004) Healing time of foot and ankle fractures in patients with diabetes mellitus: literature review and report on own cases. Zentralbl Chir 129(6):453–459

  32. 32.

    Richard JL, Almasri M, Schuldiner S (2012) Treatment of acute Charcot foot with bisphosphonates: a systematic review of the literature. Diabetologia 55(5):1258–1264

  33. 33.

    Trujillo-Santos AJ (2003) Diabetic muscle infarction: an underdiagnosed complication of long-standing diabetes. Diabetes Care 26(1):211–215

  34. 34.

    Kapur S, Brunet JA, Mckendry RJ (2004) Diabetic muscle infarction: case report and review. J Rheumatol 31(1):190–194

  35. 35.

    Yoo HG, Lee SI, Chae HJ, Park SJ, Lee YC, Yoo WH (2011) Prevalence of insulin resistance and metabolic syndrome in patients with gouty arthritis. Rheumatol Int 31(4):485–491

  36. 36.

    Lai HM, Chen CJ, Su BY et al (2012) Gout and type 2 diabetes have a mutual inter-dependent effect on genetic risk factors and higher incidences. Rheumatology (Oxford) 51(4):715–720

  37. 37.

    Bhole V, Choi JW, Kim SW, De Vera M, Choi H (2010) Serum uric acid levels and the risk of type 2 diabetes: a prospective study. Am J Med 123(10):957–961

  38. 38.

    Louthrenoo W, Sukitawut W (1999) Calcium pyrophosphate dihydrate crystal deposition: a clinical and laboratory analysis of 91 Thai patients. J Med Assoc Thai 82(6):569–576

  39. 39.

    Mavrikakis ME, Drimis S, Kontoyannis DA, Rasidakis A, Moulopoulou ES, Kontoyannis S (1989) Calcific shoulder periarthritis (tendinitis) in adult onset diabetes mellitus: a controlled study. Ann Rheum Dis 48(3):211–214

  40. 40.

    Dahaghin S, Bierma-Zeinstra SM, Koes BW, Hazes JM, Pols HA (2007) Do metabolic factors add to the effect of overweight on hand osteoarthritis? The Rotterdam Study. Ann Rheum Dis 66(7):916–920

  41. 41.

    Shakoor N, Agrawal A, Block JA (2008) Reduced lower extremity vibratory perception in osteoarthritis of the knee. Arthritis Rheum 59(1):117–121

  42. 42.

    Burner TW, Rosenthal AK (2009) Diabetes and rheumatic diseases. Curr Opin Rheumatol 21(1):50–54

  43. 43.

    Walling HW (2011) Clinical differentiation of primary from secondary hyperhidrosis. J Am Acad Dermatol 64(4):690–695

Download references



Author information

Correspondence to Ibrahim A. Al-Homood.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Al-Homood, I.A. Rheumatic conditions in patients with diabetes mellitus. Clin Rheumatol 32, 527–533 (2013) doi:10.1007/s10067-012-2144-8

Download citation


  • Diabetes
  • Joint
  • Muscle
  • Tendon
  • Treatment