The Association Between Diabetes Mellitus and Osteoarthritis: Does Diabetes Mellitus Play a Role in the Severity of Pain in Osteoarthritis?

Abstract

Osteoarthritis (OA) is one of the most prevalent degenerative joint diseases, which results in the inevitable destruction of joints leading to pain and joint immobility. Some studies have reported a potential link between diabetes mellitus (DM) and the worsening symptoms and severity of OA. Based on our literature review, the microcellular environment of patients with DM showed accelerated joint destruction and increased inflammation in every anatomical aspect of the joint including the bones, tendons, ligaments, cartilage, and synovium. Additionally, the biomechanical and biochemical properties of these tissues were more severely impacted in patients with DM and OA compared to those without DM, suggesting that DM plays an important role in the pathogenesis of OA. Specifically, we found that advanced glycation end products (AGEs) are the key to inducing the acceleration of joint destruction; however, their role in the pathogenesis has yet to be fully mapped out. In this narrative review, we aim to explore the role that DM plays in the acceleration of OA leading to increased reports of joint pain in those with both diseases. We believe this topic of discussion to be important due to the increased prevalence of both diseases over the last several decades, potentially leading to an increased medical burden on both patients and the community at large.

Health economic impact of moderate-to-severe chronic pain associated with osteoarthritis in England: a retrospective analysis of linked primary and secondary care data

“…Previous research has highlighted the association between anxiety and depression, specifically, with worsening OA-associated pain, from both the economic and patient perspectives 18–20. This might be due to requirements for treatment of comorbidities in their own right, to minimise the risks of interventions for OA, or to manage the increased pain severity that has been associated with these comorbidities in other studies 21–24…”

Metabolomic Analysis of Severe Osteoarthritis in a Spanish Population of Women Compared to Healthy and Osteoporotic Subjects

“…However, recent studies suggest that not only the increased inflammation state associated with diabetes mellitus can escalate the breakdown of joint tissues; but also lipid metabolism and glycemia alterations directly impact on cartilage health and subchondral bone [ 23 ] accelerating the progression of the disease and worsening the reported pain. The accumulation of advanced glycation end products seems to have an effect on the mechanical structure of tendons, inhibiting the differentiation and promoting the apoptosis of tendon-derived stem cells and interfering with the type I collagen organization in the extracellular matrix [ 24 ]. Our findings on leucine and valine combined with the results in other metabolites related to glucose metabolism, even when adjusted for BMD, BMI, and age, further support a potential role of type 2 diabetes on OA beyond obesity and age.…”

Could Metabolic Risk Factors Affect the Severity of Knee Osteoarthritis in Type-2 Diabetes Mellitus Patients? A Cross-Sectional Study

“…The coexistence of T2DM and knee OA, according to previous research, also increases pain perception, regardless of the radiological severity of obesity [12] [13]. There is a correlation between symptomatic knee OA and metabolic factors [14], and some studies demonstrate that hyperglycemia contributes to joint destruction in knee OA [15] [16] [17]. However, one study suggests that impaired glucose significantly affects hand OA, but no correlation with knee OA [18].…”