Musculoskeletal Complications of Diabetes Mellitus
Musculoskeletal complications are perhaps the most neglected aspect of diabetes management. Musculoskeletal complications are a diverse and common disorder observed in 30–50% of patients in diabetes from different parts of the globe. This chapter highlights the different musculoskeletal complications of diabetes and the challenges associated with their diagnosis and management. Bone health is impaired in diabetes, especially type 1 diabetes. Diabetes is associated with increased fractures due to both decreased bone density and impaired bone quality. Restriction of joint movements (adhesive capsulitis) is common in diabetes with the shoulder being the most commonly involved joint (frozen shoulder). Restriction of small joint movement in diabetes includes cheiroarthropathy. Muscle wasting in diabetes is multifactorial and may be due to neuropathy, amyotrophy, and myonecrosis among others. Carpal tunnel syndrome is a common cause of morbidity related to hand movement due to compression of the median nerve. Charcot joint involvement is a dreaded complication of diabetes related to neuropathy and altered blood flow to the involved area, leading to local inflammation, osteoclast activation, and joint erosions and destruction ultimately increasing the risk of ulcer formation, most commonly diabetic foot ulcers. Treatment of musculoskeletal complications of diabetes is largely symptomatic. Definitive therapy is mostly lacking, and prevention is the best form of cure as of today.
KeywordsAdhesive capsulitis Frozen shoulder Carpal tunnel syndrome Charcot joint Cheiroarthropathy Muscle wasting Amyotrophy