Diabetics, save your bones

You may wonder how can a blood sugar-related condition be associated with bone/joint health.

You may wonder how can a blood sugar-related condition be associated with bone/joint health. The fact is, if you have diabetes, you are at an increased risk of bone and joint ailments. Can you do anything about it? Luckily, yes! Read on to know more

Link between diabetes & bone/joint health

• The additional glucose in a diabetic patient’s blood sticks to the surface of joints, hindering their movement
• It destroys collagen. Tendons and ligaments are made from collagen. So, when the flexibility of joints is reduced, the risk of physical injury is more
• When people have joint aches/injuries, they reduce their physical activity out of fear. Reduced activity promotes insulin resistance which is bad for diabetics

Diabetes & various bone conditions
Charcot’s Joint (neuropathic arthropathy): This happens from nerve damage caused by diabetes. Breaking or twisting the foot becomes common as small breaks and sprains can put pressure on the joints of the foot

Symptoms

• Redness/swelling
• Changes in the appearance of the foot
• Numbness in ankles and feet
• Pain in the joints
• Warmness

Treatment

• Limit weight-bearing activities and use orthotic support
• Avoid using the affected foot till it heals

Rheumatoid Arthritis (RA) & Type 1 Diabetes:
One autoimmune condition increases the risk of developing another. Both Rheumatoid Arthritis and Type 1 diabetes are autoimmune disorders and can co-exist. Low bone mineral density is frequently observed in people with Type 1 diabetes

Symptoms

• Pain and swelling of joints

Treatment

• As there is no cure for RA, emphasis should be on reducing inflammation. Newer RA drugs like etanercept (Enbrel), adalimumab (Humira) and infliximab (Remicade) may be suggested by your orthopaedic surgeon

Osteoarthritis (OA) & Type 2 Diabetes:
Type 2 diabetes halts bone repair and impairs the cartilage, causing joint pains. People with Type 2 diabetes have an increased risk of OA. Obesity is the main risk factor

Symptoms

• Joint pains, swelling and stiffness, loss of joint flexibility/movement

Treatment

• Maintaining a healthy weight through a good diet. Regular exercise helps lubricate joints and relives pain
• Your orthopaedic surgeon may prescribe medication when the joint pain becomes excruciating. In most severe cases, surgery, like knee replacement, is required

Diabetic Hand Syndrome (Diabetic Cheiroarthropathy)
The skin on the hands becomes waxy and thick. Finger movement becomes limited. This painless condition is common in chronic diabetic patients with both Type 1 & 2 diabetes

Symptoms

• Fully extending fingers or pressing palms together flat becomes difficult

Treatment

• Better management of blood glucose levels and physiotherapy can slow the progress. But limited mobility may not be always reversible

Diffuse Idiopathic Skeletal Hyperostosis (DISH):
This is a kind of arthritis where the ligaments and tendons harden (calcify). These calcified areas can also form new, abnormal bone growth.

Symptoms

• Pain, stiffness, reduced range of motion in affected part of the body

Treatment

• Symptoms can be managed with pain relievers. In severe cases, surgery is required to remove the over-grown bone

Keep your bones healthy by

• Stretching & practising resistance training exercises
• Walking/swimming to improve hip & knee function
• Avoiding repetitive, high-impact exercises like running, jumping

(Dr. Dasaradha Rama Reddy Tetali, senior consultant orthopaedic surgeon, Yashoda Hospital, Somajiguda. Email: www.drtdrreddy.com)

Haddi Buddy
Dr Dasaradha Rama Reddy