Osteoarthritis risk raised by diabetes

In an article published ahead of print on September 21, 2012 in the journal Diabetes Care, European researchers reveal a significantly increased risk of severe osteoarthritis necessitating arthroplasty (joint surgery) in adults with type 2 diabetes.

The study included 927 men and women between the ages of 40 and 80 years who enrolled in 1990 in the Bruneck cohort, a prospective study of the epidemiology and pathogenesis of cardiovascular, neurologic and musculoskeletal diseases. Physical examinations conducted upon enrollment ascertained the presence of diabetes and other conditions. Sixty-nine participants met the criteria for type 2 diabetes at the beginning of the study. The subjects were evaluated at follow-up visits conducted every five years for a 20 year period.

Over follow-up, arthroplasties for severe hip or knee osteoarthritis were performed in 13 diabetic and 73 nondiabetic subjects, which was equivalent to more than double the adjusted risk of severe arthritis among the diabetic participants. In an additional analysis conducted in 2010, participants with diabetes were also found to have more severe arthritis symptoms and signs of inflammation compared to nondiabetics.

Authors Georg Schett, MD of the University of Erlangen-Nuremberg and his colleagues remark that the metabolic changes involved in obesity rather than damage to the joints caused by greater weight may be responsible for the elevated risk of arthritis observed in those with type 2 diabetes. "To our best knowledge, this is the first time that it was shown that diabetes can be considered as an independent predictor of severe osteoarthritis necessitating joint arthroplasty," they announce. "The link between osteoarthritis and type 2 diabetes suggests that alterations in glucose metabolism directly affect joint integrity independently of body weight and creates room for hope that adequate control of glucose metabolism hampers development of osteoarthritis."

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