More than 29 million Americans are affected by diabetes and the numbers continue to grow. There are two primary divisions within diabetes – type 1 and type 2. Type 1 is commonly referred to as juvenile diabetes. Type 2 is more common in adults. However, with the increase in childhood obesity, more cases of type 2 diabetes are now showing up in children.
The complications caused by diabetes can be serious and disturbing. Limb loss and heart disease are potential complications. In fact, 60 percent of all non-traumatic lower limb amputations performed in the United States are due to diabetes. Another important consideration is the serious damage diabetes can do to your bones. This can occur in several ways:
- Increased blood sugar levels inhibit bone-forming cells from building strong bones.
- Certain oral diabetic medications cause bone loss as a side effect.
- Diabetic kidney damage results in loss of calcium required for strong bones.
- Joint deterioration due to nerve damage caused by diabetes.
- Increased risk of falls resulting in bone fractures due to diabetes-related nerve damage, poor vision, and low blood sugar.
Below are various bone conditions associated with diabetes and how to treat them. Understanding how diet, physical activity, and other lifestyle factors can affect your bone mass is an important part of a healthy lifestyle. These factors can help to build strong bones and control the impact of diabetes.
- Osteoporosis: Low bone mineral density resulting in weak bones and potential fractures. People with type 1 diabetes are at an increased risk.
- Management: A healthy lifestyle which includes weight-bearing exercises and a diet rich in calcium and vitamin D is the best way to treat this condition.
- Osteoarthritis: Involves inflammation of the tissues in the joints and damage to the cartilage. The inflammation can cause swelling, pain in the joints, and a loss of flexibility or movement in the joints.
- Management: Leading an active lifestyle, avoiding too much stress on the joint and surgical repair in case of severe deterioration of the joint are useful for relief.
- Charcot Joint: Also known as neuropathic arthropathy, most commonly affects the feet. Joint deterioration due to diabetes-related nerve damage causing numbness, tingling, and loss of sensation usually in the feet. Feet may also become unstable, swollen or deformed.
- Management: Early detection and treatment of diabetes can halt the worsening of symptoms. Use of orthotic supports and limited weight-bearing can also be helpful.
- Diabetic Hand Syndrome: Also known as diabetic cheiroarthropathy, causes the skin on the hands to become waxy and thickened. This can cause finger movement to become limited or the inability to press the palms together.
- Management: Physical therapy and improved blood glucose management helps to slow progression of this condition.
- Diffuse Idiopathic Skeletal Hyperostosis: Also known as Forestier disease, it causes hardening of the ligaments and tendons usually affecting the spine. This results in pain and stiffness of the back or neck.
- Management: Your doctor may prescribe medications to help relieve pain. In rare cases, surgical removal of abnormal bone formation is recommended.
- Dupuytren’s Contracture: Thickened and scarred connective tissue of the palm and fingers causes a deformity of the hand in which one or more fingers bend toward the palm of the hand.
- Management: Steroid and enzyme injections are usually administered to break apart the thick tissue. Surgery is indicated in severe cases.
- Frozen Shoulder: Shoulder pain, stiffness of the joint and limitation in range of motion of the shoulder. This typically only presents itself in one shoulder.
- Management: Physical therapy and surgical measures are the treatment choices to preserve range of motion.
Dr. Benjamin Domb is a nationally recognized orthopaedic surgeon specializing in sports medicine and arthroscopic surgery of the hip, shoulder and knee. A noted pioneer in advanced new techniques in hip arthroscopy, he delivers innovative treatments for patients with hip injuries such as impingement and labral tears. Dr. Domb is also an expert in arthroscopic surgery of the shoulder and knee, adept in specialized techniques including arthroscopic rotator cuff repair and all-inside ACL reconstruction. You can learn more about him here.