Diabetes is a lifelong condition that causes a person’s blood sugar level to become too high.
There are two main types of diabetes:
type 1 diabetes – where the body’s immune system attacks and destroys the cells that produce insulin
type 2 diabetes – where the body doesn’t produce enough insulin, or the body’s cells don’t react to insulin
Type 2 diabetes is far more common than type 1. In the UK, around 90% of all adults with diabetes have type 2.
Visit your GP as soon as possible if you experience the main symptoms of diabetes, which include:
- feeling very thirsty
- urinating more frequently than usual, particularly at night
- feeling very tired
- weight loss and loss of muscle bulk
- cuts or wounds that heal slowly
- blurred vision
Type 1 diabetes can develop quickly over weeks or even days.
Many people have type 2 diabetes for years without realising because the early symptoms tend to be general.
Causes of Diabetes
The hormone Insulin, (produced by the Pancreas) controls the sugar in our blood.
When food is digested and enters the bloodstream, insulin moves glucose, (sugar) out of the blood and into cells, where it’s broken down to produce energy.
However, if you have diabetes, your body is unable to break down glucose into energy, due to lack of or poorly functioning insulin.
Healthy eating, regular exercise and regulating blood glucose is needed to help manage Diabetes.
People diagnosed with type 1 diabetes often require regular insulin treatment for the rest of their life, usually in the form of injections or a pump.
As type 2 diabetes is a progressive condition, medication may eventually be required, usually in the form of tablets. Diet and lifestyle changes may also be necessary.
Diabetes may affect the musculoskeletal system in a variety of ways, via the metabolic system, and the vascular system, resulting in changes in the connective tissue. Musculoskeletal complications are most commonly seen in patients with a longstanding history of Diabetes.
Areas more commonly affected are the hands, with joint stiffness and tightening of the soft tissues in the hands and fingers.
Carpal tunnel syndrome (CTS) is seen in up to 20% of diabetic patients. Its specific relationship to diabetes is thought to be median nerve entrapment caused by the diabetes-induced connective tissue changes. Symptoms may include burning, tingling, or sensory loss in the fingers and sometimes pain in the fingers and forearm. There may also be muscle weakness affecting the hand.
Diabetes has been linked to a painful, stiff shoulder, or frozen shoulder. Patients report shoulder stiffness, along with decreased range of motion. Therapy is largely conservative and involves gentle stretching/range of motion exercises, and the use of analgesics and/or intra-articular injections.
The changes in sensation that can occur with long standing Diabetes may also affect joints such as the feet, where loss of sensation can lead to micro-trauma and joint changes.
Diabetes quite commonly affects the musculoskeletal system, However, many of these complications are treatable, monitoring for signs of musculoskeletal complications can be an invaluable part of overall diabetes care.
Physiotherapists are well placed to assess and assist with the management and treatment of musculoskeletal issues for Diabetic patients.
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