Diabetes and musculoskeletal complications

Diabetes and Tendon Damage

A June 2022 study (1) examined the association between Diabetes mellitus and musculoskeletal complications-including tendon dysfunction and injury. The researchers write: “Patients with Diabetes show altered foot and ankle mechanics that have been attributed to tendon dysfunction as well as impaired recovery post-tendon injury. Despite the problem of Diabetes-related tendon complications, treatment guidelines specific to this population of individuals are lacking. Diabetes impairs tendon structure, function, and healing capacity in tendons throughout the body, but the Achilles tendon is of particular concern and most studied in the diabetic foot. At macroscopic levels, asymptomatic, diabetic Achilles tendons may show morphological abnormalities such as thickening, collagen disorganization, and/or calcific changes at the tendon enthesis.  . . In addition to dysfunction of the extracellular matrix, tendon cells such as tenocytes and tendon stem/progenitor cells show significant abnormalities in proliferation, apoptosis, and remodeling capacity in the presence of hyperglycemia and advanced glycation end-products, thus contributing to the disruption of tendon homeostasis and healing.”

Diabetes and Lumbar Stenosis

A December 2023 large-scale retrospective case-control study (x) looked at a total of 49,576 patients diagnosed with lumbar spinal stenosis for an association between spinal stenosis and diabetes. The theory was that patients with diabetes mellitus would present a greater risk factor for developing lumbar spinal stenosis. The researchers “found a higher likelihood of lumbar spinal stenosis diagnosis in diabetic patients. Those (patients with HbA1c ≥7% and 1 or more diabetes-related complication also had an elevated likelihood.

1 Vaidya R, Lake SP, Zellers JA. Effect of Diabetes on Tendon Structure and Function: Not Limited to Collagen Crosslinking. Journal of Diabetes Science and Technology. 2022 Jun 2:19322968221100842.
2 Shemesh S, Laks A, Cohen I, Turjeman A, Blecher R, Kadar A. Diabetes Mellitus and Poor Glycemic Control are Associated with a Higher Risk of Lumbar Spinal Stenosis: An Analysis of a Large Nationwide Database. Spine.:10-97.


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