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Chapter-025 Musculoskeletal Effects of Diabetes Mellitus

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Bajaj Sarita
2. Singla Rajiv
ISBN
9789351526476
DOI
10.5005/jp/books/12535_32
Edition
2/e
Publishing Year
2015
Pages
7
Author Affiliations
1. MLN Medical College, Allahabad, India, MLN Medical College, Allahabad, Uttar Pradesh, India, Moti Lal Nehru Medical College, Allahabad 211 001, UP, India, South Asian Federation of Endocrine Societies (SAFES); Moti Lal Nehru Medical College, Allahabad, Uttar Pradesh, India, Moti Lal Nehru Medical College, Allahabad, Uttar Pradesh, India, Moti Lal Nehru Medical College, Allahabad, UP, India, MLN Medical College, Allahabad (UP), India, Motilal Nehru Medical College, Allahabad, Uttar Pradesh, India
2. Maulana Azad Medical College, New Delhi, India, Maulana Azad Medical College and Lok Nayak Hospital, University of Delhi, New Delhi, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India, Saket City Hospital, Delhi, India
Chapter keywords
Diabetic myonecrosis, diabetic lumbosacral plexopathy, shoulder adhesive capsulitis, stenosing flexor tenosynovitis, Dupuytren’s contracture, calcific tendinitis, diabetic foot

Abstract

This chapter emphasis about the musculoskeletal complications of diabetes that affects the quality of patient’s life. Type 1 and type 2 diabetes are mainly associated with poor bone health and increased fracture rate, but their effect on bone mineral density varies. The changes in mitochondrial function, reduced lipid oxidation, increased cellular stress response and enhanced detoxification mechanisms results in alterations in contractile proteins and cytoskeletal proteins. Diabetic myonecrosis is commonly seen in insulin dependent patients with microvascular complications. Amyotrophy occurs in type 2 patients usually presents with acute onset proximal leg pain followed by muscle weakness. About one third of the patients suffer with distal and proximal sensory loss. The effects of diabetes in joint and connective tissue causes shoulder adhesive capsulitis, diabetic cheiroarthropathy, Dupuytren’s contracture and stenosing flexor tenosynovitis. Calcific tendinitis may occur with adhesive capsulitis in the shoulder due to the deposit of calcium hydroxyapatite crystals in periarticular areas. The other diseases namely diffuse idiopathic skeletal hyperostosis, diabetic foot and osteoarthritis are also associated with diabetes.

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