Rheumatologic manifestations in diabetes

Czech version

Authors: J. Vencovský
Authors‘ workplace: Revmatologický ústav, Praha, ředitel prof. MUDr. Karel Pavelka, DrSc.
Published in: Vnitř Lék 2006; 52(5): 481-484
Category: Diabetes and other subjects (infection, dermatovenerology and rheumatology) Hradec Králové 3 to 4 June 2005

Overview

Patients with diabetes mellitus may encounter various musculoskeletal complications. Typical manifestations can be seen in the hand, such as limited joint mobility, flexor tendon synovitis, Dupuytren’s contracture and carpal tunnel syndrome. Humeral periarthropathy is also more frequent. The most serious complications can occur in the form of diabetic foot, which may lead to severe deformities and disability. Diabetic amyotrophy and muscle infarction are more rare complications. While osteopenia has a well recognized association with type I diabetes mellitus, this probably is not true for type II. Similarly, the association between diabetes mellitus and osteoarthritis has not been proven.

Key words:
diabetes mellitus - joint manifestations - diabetic foot

Sources

1. Kapoor A, Sibbitt WL jr. Contractures in diabetes mellitus: the syndrome of limited joint mobility. Semin Arthritis Rheum 1989; 18: 168-180.

2. Lindsay JR, Kennedy L, Atkinson AB et al. Reduced prevalence of limited joint mobility in type 1 diabetes in a U.K. clinic population over a 20-year period. Diabetes Care 2005; 28: 658-661.

3. Eaton RP, Sibbitt WL jr, Shah VO et al. A commentary on 10 years of aldose reductase inhibition for limited joint mobility in diabetes. J Diabetes Complications 1998; 12: 34-38.

4. Sibbitt WL jr, Eaton RP. Corticosteroid responsive tenosynovitis is a common pathway for limited joint mobility in the diabetic hand. J Rheumatol 1997; 24: 931-936.

5. Bland JH, Frymoyer JW, Newberg AH et al. Rheumatic syndromes in endocrine disease. Semin Arthritis Rheum 1979; 9: 23-65.

6. Arkkila PE, Kantola IM, Viikari JS et al. Shoulder capsulitis in type I and II diabetic patients: association with diabetic complications and related diseases. Ann Rheum Dis 1996; 55: 907-914.

7. Vencovský J, Broulík P. The endocrine system. In: Isenberg DA, Maddison PJ et al. Oxford Textbook of Rheumatology. 3rd ed. Oxford: Oxford University Press 2004: 185-192.

8. Fogács SS Diabetes mellitus. In: Hochberg MC, Silman AJ et al. Rheumatology. 3rd ed. London: Elsevier Mosby 2003: 1977-1982.

9. Sinha S, Munichoodappa CS, Kozak GP. Neuro-arthropathy (Charcot joints) in diabetes mellitus (clinical study of 101 cases). Medicine (Baltimore) 1972; 51: 191-210.

10. Cavanagh PR, Young MJ, Adams JE et al. Radiographic abnormalities in the feet of patients with diabetic neuropathy. Diabetes Care 1994; 17: 201-209.

11. Armstrong DG, Peters EJ Charcot's arthropathy of the foot. J Am Podiatr Med Assoc 2002; 92: 390-394.

12. Sella EJ, Barrette C. Staging of Charcot neuroarthropathy along the medial column of the foot in the diabetic patient. J Foot Ankle Surg 1999; 38: 34-40.

13. Jude EB, Selby PL, Burgess J et al. Bisphosphonates in the treatment of Charcot neuroarthropathy: a double-blind randomised controlled trial. Diabetologia 2001; 44: 2032-2037.

14. Sella EJ, Grosser DM. Imaging modalities of the diabetic foot. Clin Podiatr Med Surg 2003; 20: 729-740.

15. Coppack SW, Watkins PJ. The natural history of diabetic femoral neuropathy. Q J Med 1991; 79: 307-313.

16. Silberstein L, Britton KE, Marsh FP et al. An unexpected cause of muscle pain in diabetes. Ann Rheum Dis 2001; 60: 310-312.

17. Melchior TM, Sorensen H, Torp-Pedersen C Hip and distal arm fracture rates in peri- and postmenopausal insulin-treated diabetic females. J Intern Med 1994; 236: 203-208.

18. van Daele PL, Stolk RP, Burger H et al. Bone density in non-insulin-dependent diabetes mellitus. The Rotterdam Study. Ann Intern Med 1995; 122: 409-414.

19. Frey MI, Barrett-Connor E, Sledge PA et al. The effect of noninsulin dependent diabetes mellitus on the prevalence of clinical osteoarthritis. A population based study. J Rheumatol 1996; 23: 716-722.

20. Horn CA, Bradley JD, Brandt KD et al. Impairment of osteophyte formation in hyperglycemic patients with type II diabetes mellitus and knee osteoarthritis. Arthritis Rheum 1992; 35: 336-342.