According to the CDC, 21.0 million of Americans currently have a diagnosis of diabetes, while an additional 8.1 million people have undiagnosed diabetes. Whether they are aware of their diagnosis or not, many of the 29.1 million (9.3% of the population) sufferers are likely unaware that osteoarthritic hand pain is linked to a diabetes diagnosis.
It is important to understand that arthritis does not cause diabetes and diabetes does not arthritis. However, they often overlap. According to the CDC, 52% of diabetic patients also suffer from some form of arthritis. The following explores the current theories regarding the link between the two diseases, as well as why hand pain tends to be more severe in patients with both conditions.
Diabetes and Osteoarthritis
Both Type 2 diabetes and OA share two major risk factors, weight and age. As a result, it is more than likely completely coincidental that they occur together. Being overweight is well known for aggravating the joints by putting them under excessive stress. This contributes to the wear and tear of the cartilage that causes arthritis. Obesity is also a common cause of type 2 diabetes. The excess fatty tissues in the body produce chemical compounds that increase the body’s resistance to insulin, thus blood glucose levels to rise
Additionally, as an individual grows older, the more he or she has used their joints. This causes more wear and tear, making them more likely to develop OA. The risk for type 2 diabetes also rises with age. This is most likely attributed to people becoming less active, losing muscle mass, and gaining weight.
Diabetes and Rheumatoid Arthritis
Both Type 1 diabetes and rheumatoid arthritis are autoimmune diseases, meaning the body attacks healthy cells within the body. In type 1 diabetes, the immune system attacks the pancreas, the organ in which insulin is produced. With rheumatoid arthritis, the immune system focuses on destroying the synovial lining of the joints.
Research has identified a genetic connection between diabetes and RA. A specific gene, PTPN22, strongly correlates with the occurrence of RA and type 1 diabetes, as well as other autoimmune diseases. In addition, individuals with RA typically have increases levels of inflammatory markers including interleukin-1 (IL-1) and C-reactive protein (CRP). These two markers are frequently also found to be elevated in individuals diagnosed with type 1 diabetes, though not type 2 diabetes.
The Changes Diabetes Can Have on the Musculoskeletal System
Diabetes symptoms has been shown to cause musculoskeletal changes that result in symptoms commonly experienced by arthritis sufferers. This includes joint stiffness, joint pain, inflammation, and the formation of nodules under the skin, especially in the fingers.
Understanding the Relationship between Diabetes and Increased Hand Pain in Arthritis Sufferers
Unlike the knees, hips, and ankles, the hands are non-weight bearing joints. As a result, it would be easy to assume that type 2 diabetics, who are overweight, would be more likely to experience severe pain in joints other than the hands, but this is not the case. Researchers have investigated why there so many diabetics with arthritis complain of hand pain, but the results are not well understood. However, it is believed to be related to the thickening and stiffening of the connective tissues that both conditions are known for causing. It is also thought that high blood glucose levels alter protein balance resulting in enhanced stiffening of the collagen.
While there are many, here are just a few of the better known diabetes-related joint conditions. They include:
Diabetic stiff hand syndrome, a relatively painless disorder that results from increased collagen in and just below the skin. This can significantly limit hand function.
Trigger finger is a condition in which one or more of the fingers curl up and are extremely difficult to straighten back out. The tendons that allow for the bending and straightening of the fingers may “catch” and “click” open again. This is more prevalent in the morning and can be incredibly painful.
Carpal tunnel syndrome, a painful condition that results from pressure on the median nerve (that passes through a narrow “tunnel” into the hand) is also more common in individuals with both arthritis and diabetes.
If you suffer from arthritis or diabetes, it is important to be alert for signs or symptoms that you may also be developing the other disease. Be sure to make your physician aware of any problems you may be experiencing.