Diabetes patients at elevated risk of arthritis and osteoporosis

Diabetes is associated with a greater risk of having osteoarthritis, rheumatoid arthritis, and osteoporosis, suggests a new study involving over 109,000 people. The study was presented at the European Association for the Study of Diabetes (EASD) Annual Meeting in Berlin, Germany.

Arthritis is a common disease affecting 350 million people worldwide. Osteoarthritis, caused by damage to the cartilage in the joints, is the most common form of arthritis. In rheumatoid arthritis, the joint lining becomes inflamed as an autoimmune disease that affects the entire body.

Previous research has reported higher levels of musculoskeletal pain in people with type 2 diabetes compared to their diabetes-free counterparts and the general population. But whether this pain is the result of an increased prevalence of arthritis was unclear until now.

In the study, people with diabetes were 33% more likely to suffer from osteoarthritis than their diabetes-free counterparts. Similarly, the odds of having rheumatoid arthritis (70% higher) and osteoporosis (29% higher) were considerably greater among individuals with diabetes.

Using self-reported data from the 2013 Danish National Health Survey, researchers explored the connection between diabetes and osteoarthritis, rheumatoid arthritis, and osteoporosis in over 109,200 people (aged 40 years or older). Analyses were adjusted for risk factors influencing arthritis including age, gender, and body mass index (BMI).

Diabetes was diagnosed in 9238 (8.5%) participants. People with diabetes tended to be older, were more often male, had higher BMI, and were most likely to have osteoarthritis.

Results showed that people with diabetes were 27% more likely to report suffering from back pain and 29% more likely to have shoulder/neck pain compared with their diabetes-free peers.

Further analyses revealed that the more physically active people with diabetes were, the lower their risk of back pain and shoulder/neck pain.

The authors speculate that the strong association between rheumatoid arthritis and diabetes is likely to be the result of chronic inflammation or steroid treatment that can lead to type 2 diabetes, rather than a link between the autoimmune diseases type 1 diabetes and rheumatoid arthritis. They point out that the exclusion of people younger than 40 meant that the majority of those included in the study probably had type 2 diabetes.

"It's likely that the chronic pain experienced by people with arthritis may be a barrier to exercising, which is also a risk factor for type 2 diabetes", explains Dr Stig Molsted from Nordsjaellands University Hospital, Hillerød, Denmark. "Health care professionals should make patients with diabetes aware that regular exercise is a recognized treatment for diabetes and arthritis, and can have positive effects on both blood sugar control as well as musculoskeletal pain."

This is an observational study, so no firm conclusions can be drawn about cause and effect, and the authors point to several limitations including that the study is based on self-reported data which could have affected the results