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Friday, September 19, 2014
Long term effects of diabetes
Have there been found to be any long term problems with weakening of the joints, ie: the knees, elbows, fingers due to diabetes or treatments thereof? My husband is 36 years old and was diagnosed with type II diabetes at age 25. He is now having a tremendous amount of pain in his knees. I have asked our family doctor, the urgent care doctor, and the endocronologist about this - they all seem to think this condition is NOT a result of the diabetes. Can you answer this question or lead me in the right direction to look for the answer?
Most of the time arthritis is a separate issue from diabetes but there are three ways I can think of that there is some common denominator between diabetes and arthritis - I'm not sure any of these in particular necessarily apply to your husband.
Type 2 diabetes is frequently associated with obesity which in turn is an important cause of degenerative or osteoarthritis in weight bearing joints, as a result of the excess weight. It is unusual for this to be manifest at this young an age unless the person were profoundly overweight.
Type 1 Diabetes is an autoimmune disorder as is rheumatoid arthritis - there is probably some population although relatively small that have both of these autoimmune disorders, possibly due to some common mechanisms.
High blood sugar of whatever origin can cause sugar molecules to attach to proteins - when it attaches to connective tissue proteins. This has more prominent effects on skin and tissue under the skin but can affect joints. People with diabetes are more likely to develop problems like carpal tunnel syndrome, a problem causing pain in the hands. It is not so clearcut how much effect this has on large joints like knees but some variation on this theme might be at work in this instance.
Treatment for obesity effects would be weight loss; for rheumatoid arthritis would be the same forms of therapy used in people with rheumatoid arthritis without diabetes (except one might try to be more careful with using steroids); and for the last mechanism would be controlling the blood sugars.
Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati