Many studies seem to indicate an association between rheumatoid arthritis and type 1 diabetes.
According to the Arthritis Foundation, both conditions are autoimmune diseases, with inflammation as the common condition in both.
In a person with type 1 diabetes, the insulin-producing pancreas is attacked, which means the person does not produce insulin.
In a person with rheumatoid arthritis, the body attacks the tissues lining the joints.
In addition, people who have rheumatoid arthritis have high levels of what are called inflammatory markers in their systems.
For example, C-reactive protein, or CRP, is a marker that is also found in increased levels in people with type 1 diabetes.
Is there a connection between type 2 diabetes and osteoarthritis?
Some researchers believe there is a connection between people with type 2 diabetes and osteoarthritis, but it is not because of inflammation, as with type 1 diabetes and rheumatoid arthritis.
Because it is estimated that up to 80 percent of people with type 2 diabetes are overweight or obese, the additional weight puts stress on the joints, especially those of the lower body.
In addition, the pancreas has to produce more insulin to compensate for the excess glucose in people with type 2 diabetes.
This means the heart and blood vessels are stressed, causing problems with blood flow to joints.
Because of these added stressors on the joints, osteoarthritis of the knee and hip are often found in people with type 2 diabetes.
How are musculoskeletal problems in the body connected to glucose?
The term musculoskeletal means something that is connected to both muscles and bones in the body.
It usually implies the range of motion in the hands, wrists, shoulders, and other joint areas and concentrates on the connective tissues surrounding the joints.
According to Harvard Medical School and the American Diabetes Association, many musculoskeletal complications stem from changes in these connective tissues, including in people who have diabetes.
These complications should not be confused with osteoarthritis (see above) but mostly appear to result from the attachment of glucose to the connective tissues.
This often results in the stiffening of joints all over the body.
What hand problems do people with diabetes sometimes face?
Many people with diabetes face musculoskeletal problems, especially of the hands.
For example, diabetic stiff hand syndrome (or diabetic cheiroarthropathy) is a disorder that causes the skin on the fingers to become thick, tight, and waxy, thus causing the fingers, and often the entire hand, to become limited in movement.
Usually, the first sign is a problem keeping the fingers together without leaving a gap (it is often called a “prayer sign”).
It is thought to be caused by several reasons, including consistently high blood glucose levels that cause excess collagen (a structural protein that literally holds the body together) in the skin.
At this writing, there is no cure for the syndrome.
Why is arthritis often connected to foods a person eats?
A rthritis appears to be an ailment that is affected by what a person eats. Many studies indicate that some foods, such as processed or fried foods, cause more inflammation in our bodies. Foods such as fresh vegetables and fruits, along with nuts and teas, can cut back on the inflammation that affects a person’s arthritic joints.
Flexor tenosynovitis, also called trigger finger, is an inflammation of the finger tendons that makes them hard to move.
Another problem with the hands, again in the fingers, is called trigger finger, or flexor tenosynovitis. This occurs when the tendon (and the sheath around it) that extends into the finger or thumb becomes inflamed. Lumps (nodules) can form on the tendon, causing it to stop moving correctly through the sheath and stopping the finger from moving. This causes the finger to become locked in a bent or straight position, thus the term trigger finger.
Yet another hand problem for many people with diabetes has to do with the tissue under the skin of one or both palms. Dupuytren’s contracture is when the palm’s skin becomes thicker and tightens. If left to thicken over several years, it can lead to pain, stiffness, and the inability to straighten the finger joints, especially affecting the middle and ring fingers. Certain treatments are often suggested, including surgery to break apart the thick tissues or injections of steroids into the palm.
Do people with diabetes have more problems with carpal tunnel syndrome?
One of the more well-known musculoskeletal wrist problems for people with diabetes, and those who do not have diabetes, is called carpal tunnel syndrome.
It is caused by the thickening or swelling of the tendons found in the wrist, which compress the nerve that runs from the forearm into the hand.
The most common symptoms include burning, shooting pains, and numbness in the hand and/or the wrist.
It is mostly caused by repetitive movement (and thus called a repetitive injury) for most people.
It is estimated that up to 20 percent of people with diabetes experience carpal tunnel problems, primarily because their nerves are more sensitive to compression from a repeated motion. (For more about nerve damage and diabetes, see the chapter “How Diabetes Affects the Nervous System.”) For many people, the treatment can include steroid injections to reduce inflammation and physical therapy.
But for more severe cases, surgery is often suggested to cut the connective tissue that is putting pressure on the nerve.
What shoulder problems do people with diabetes sometimes face?
People with diabetes often face a musculoskeletal problem with their shoulders called adhesive capsulitis, or frozen shoulder.
This occurs when the shoulder gradually stiffens, causing pain and decreasing the joint’s range of motion.
Although it is not fully understood what causes a frozen shoulder, it is usually found in association with other musculoskeletal problems, such as in people with diabetes (especially those who have such diabetic-related conditions such as retinopathy and neuropathy), thyroid disease, or certain autoimmune diseases.
Frozen shoulder can be difficult to treat.
The most common treatments range from administering medications for pain (such as nonsteroidal anti-inflammatory drugs [NSAIDs] or corticosteroid oral medications [for example, prednisolone] or corticosteroid injections in the joint), physical therapy for stretching the joint, and/or arthroscopic surgery to cut the adhesions that are usually involved in restricting the joint’s mobility.
What recent study indicated that diabetes may be linked to tendon pain?
It is known that chronically high blood glucose levels can increase the risk of developing tendinopathy, a condition that commonly causes the tendons to thicken.
If a person has tendinopathy, then he or she usually has painful and inflamed tendons when exercising or with movement and, in particular, in response to overuse.
A recent study showed there may be a link between type 2 diabetes and tendon pain.
The researchers discovered that people with diabetes are more than 3.5 times as likely as those without diabetes to have tendon pain (and if severe, tendinopathy) in any tendon of the body.
They also found that those with tendinopathy were 1.3 times more likely to have type 2 diabetes.
The study also showed that the risk of tendinopathy also increases with the number of years a person has diabetes.
Is there a connection between diabetes and bone fractures?
There is evidence that people with both type 1 and type 2 diabetes have a higher incidence of bone fractures than the general population.
In fact, although people with type 2 diabetes usually have above-average bone density (carrying around extra weight helps maintain bone density, as does weight-bearing exercise), they still have more bone fractures.
For example, two recent studies showed that people with type 1 diabetes had a risk of hip fracture 6.3 to 6.9 times higher, and those with type 2 diabetes 1.4 to 1.7 times higher, compared with people without diabetes.
The reasons for these bone fracture and diabetes connections are unknown.
Why is osteoporosis associated with bone fractures?
O steoporosis is a bone disease that causes an increase in the risk of fractures and breaks, usually in older adults.
Osteoporosis occurs when the person’s bone mineral density decreases, causing the bones to deteriorate.
This deterioration causes a loss of bone strength, lower bone mass, and a higher risk of fracturing the bones of the hip, spine, and wrist.
In advanced osteoporosis, the bone is literally porous, with small holes altering the bone structure, which allows the bones to break more easily. (For more about osteoporosis, see the chapter “Who Gets Diabetes?”) According to the most recent data, it is estimated that around 10 million Americans have osteoporosis.
It is considered to be the most common type of bone disorder in both females and males, although more females experience the disease.
But there are several theories.
One suggestion is that most people with type 2 diabetes are overweight or obese, making balance and coordination more difficult.
Thus, people with diabetes and larger body size (and high bone mass) may have higher fracture rates because of balance problems.
In addition, many people with diabetes (type 1 and type 2) have peripheral neuropathy and/or vision problems, making them more likely to fall and fracture a bone.
And if a person with diabetes (type 1 or 2) experiences a hypoglycemic (low blood glucose) episode, he or she may fall and fracture or break a bone, as low blood glucose causes the person to be confused or even pass out.
DIABETES AND MUSCLES
How many muscles are in the average human body?
Most research says there are about 650 muscles in the average human body, although the numbers vary from one person to another. But other scientists believe there may be as many as 850 muscles, depending on how you categorize and look at each muscle group.
What are the three main types of muscle tissue?
The three main types of muscle tissue are as follows
Smooth muscles , found in the walls of blood vessels, in the walls of major organs (digestive, respiratory, urinary, and reproductive tracts), and in the iris of the eye.
Cardiac muscles , as the name implies, found only in the heart; they are responsible for pumping blood throughout the body.
Skeletal muscles , attached to tendons, which, in turn, are attached to bones; they help with the movement of the body.
Where are sources of energy stored for muscle cells?
The muscle cells that make up the body’s muscles use various sources to power their contractions.
For example, if they need quick energy, they can use stored molecules in the cells (called ATP and creatine phosphate), which are usually depleted after about 20 seconds of activity.
Then the muscles switch to other sources, especially glycogen (a carbohydrate made up of a string of glucose molecules).
It is glycogen that helps the body make it through workouts, whether a person is lifting weights or running, and glycogen originates with the foods a person eats.
The following lists the major sources of energy for the body’s systems and where the sources are stored in the body:
Adenosine triphosphate (ATP) is a chemical that helps store energy in cells, including muscle cells, which can use the energy to contract.
Body System Sources of Energy
Source
Storage Site
Carbohydrates
Glycogen; there is an average of 500 grams stored most of the time in the average human, mainly in the liver and skeletal muscles.
Fats (lipids)
Adipose tissue (although it has several other tasks) stores energy in our system as fats (in the form of triglycerides); it is estimated that a healthy adult male has 12 to 18 percent body fat, while healthy adult females carry about 12 to 25 percent body fat.