Musculoskeletal Complication of Diabetes

Diabetes is a common problem in society today and is becoming increasingly common. The impacts of the high blood glucose levels have both acute and chronic consequences if the person who has it does not follow the guidelines and recommendations to keep those blood glucose levels under control. These strategies include exercise and diet as well as medication and insulin depending on the type and nature of their condition that they have.

The acute consequences can include a hyperglycaemic episode in which the blood glucose levels rise. The symptoms of this include a fruity-smelling breath, nausea, dry mouth and eventually confusion and a coma. The opposite is a hypoglycaemic attack in which the blood glucose levels drop which results in the symptoms of sweating, feeling tired, dizziness, feeling hungry, a tingling of the lips and a feeling shaky or trembling with a fast or pounding heartbeat. They also tend to be easily irritated, tearful, or anxious. Both the hypo- and hyper- episodes need to be dealt with promptly.

If the blood glucose levels are high too often then there is an increased chance of developing the more chronic complications that can occur. This is because of the damage that the higher blood levels do to all the body’s tissues. The more common chronic complication is that of diabetic neuropathy. This means the nerves loses the ability to sense things properly and starting in the feet, they start to go numb. The danger of this is that if there is some trauma from an accident or something like a painful blister on the foot, the person with the nerve damage will not feel it. The problem will affect the circulation so that when damage does happen, the body has a lowered immune response so the healing is impaired.

When it is long standing also commonly affects the eye and kidneys. With the eye damage, there is a common condition called diabetic neuropathy that affects the ability to see clearly. It is easily treated if it is picked up early. The kidney damage can be quite serious and sometimes those with diabetes who develop the kidney problems end up on dialysis. The kidneys are important to help filter toxic and waste products out of the body, so it is easy to see why losing that ability is potentially serious. There are urine and blood tests that can be done to keep an eye out for the kidney problems.

For the musculoskeletal system, the high blood sugars alters the properties of the connective tissues. This makes the joints stiffer with a condition known as limited joint mobility. The stiffness with this in the foot leads to problems with walking and in the hands, it can lead to a deformity called the prayer sign in which they cannot get their palms together. The wasting of the muscles that can occur as the nerve damage in the foot can lead to a deformity that gets called the intrinsic minus foot. The joints can become quite stiff over the long term if the blood glucose levels are not kept under control. Complications of the diabetic foot are common and those with signs and symptoms need to take special care to look after their feet.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.