Type 1 diabetes can cause musculoskeletal problems, study suggests

·3-min read

Scientists have identified four conditions which should be considered complications of type 1 diabetes, including frozen shoulder and carpal tunnel syndrome.

Research presented at the Diabetes UK Professional Conference (DUKPC) 2021 suggests type 1 diabetes is likely to directly cause certain musculoskeletal conditions.

By analysing genetic and health data, researchers identified four conditions which they argue should now be considered as complications of type 1 diabetes.

It is known that some musculoskeletal conditions – which affect the muscles, bones, and joints – are more common in people with the condition.

However, until now it has not been clear whether type 1 diabetes is a direct cause, or whether there are other factors in play.

The team of researchers, led by Dr Harry Green at the University of Exeter, analysed data from UK Biobank – one of the largest health studies in the world – and FinnGen, a similar database in Finland.

They used genetic and health information to investigate whether people with type 1 diabetes were more likely to develop a range of common conditions.

When a link between type 1 diabetes and another health condition was discovered, the team used a statistical technique called Mendelian randomisation to understand whether type 1 diabetes played a causal role.

The analysis revealed that type 1 diabetes directly increased the risk of developing frozen shoulder, trigger finger, carpal tunnel syndrome and Dupuytren’s contracture.

They are all musculoskeletal conditions that are characterised by pain and reduced mobility in the shoulder, hand, wrist, or fingers.

Researchers say these conditions should now be considered alongside kidney failure, heart attacks and stroke, as complications of type 1 diabetes that result from high blood sugar levels.

However, type 1 diabetes was not found to play a causal role in the development of osteoarthrosis – degeneration of joints.

It is thought that raising awareness among healthcare professionals that these four musculoskeletal conditions are chronic complications of type 1 diabetes will facilitate early diagnosis and timely treatment, and improved outcomes for people living with type 1 diabetes.

Dr Harry Green, independent research fellow at the University of Exeter, said: “Many conditions are known to be associated with diabetes, but it is often unclear whether diabetes has a direct causal role or is associated for other reasons.

“We hope that understanding more about the causal role that type 1 diabetes and long-term high blood sugars play in the development of musculoskeletal conditions will pave the way for these conditions to be recognised earlier in patients with diabetes.”

Type 1 diabetes is an autoimmune condition that occurs when the body’s immune system attacks the insulin-producing cells of the pancreas.

This means the pancreas can no longer produce insulin, leading to high blood sugar levels.

Around 8% of the 3.9 million people in the UK who have been diagnosed with diabetes have type 1.

Dr Elizabeth Robertson, director of research at Diabetes UK, said: “Dr Green’s research has shown, for the first time, that several musculoskeletal conditions can be a direct complication of type 1 diabetes.

“People with type 1 diabetes should now be made aware of these conditions, alongside established complications such as heart and kidney disease.

“These results are a reminder of the importance of supporting people with type 1 diabetes to manage their blood sugar levels so that they can live well with the condition and avoid future complications.

“It is crucial that healthcare professionals are aware of these complications, so they are armed with the knowledge to facilitate early diagnosis and treatment, ensuring the best possible care for people with type 1 diabetes.”

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