Cheiroarthropathy and tendinopathy in diabetes

Area of Science:

• Endocrinology
• Rheumatology
• Diabetology

Background:

• Joint problems are common in individuals with diabetes mellitus.
• Cheiroarthropathy, characterized by painless limited finger joint extension, is associated with diabetes duration and microvascular complications.
• Tendinopathy prevalence is higher in diabetic patients, linked to obesity and insulin resistance.

Purpose of the Study:

• To review the pathogenesis and management of diabetes-related joint complications, specifically cheiroarthropathy and tendinopathy.
• To explore potential mechanisms underlying these conditions in diabetes.
• To discuss current management strategies for these joint issues.

Main Methods:

• Literature review of studies on diabetes, joint complications, cheiroarthropathy, and tendinopathy.
• Analysis of proposed pathophysiological mechanisms including collagen glycation and hyperinsulinaemia-driven changes.
• Synthesis of information on conservative management approaches.

Main Results:

• Prevalence of cheiroarthropathy may be decreasing with better glycemic control.
• Non-enzymatic collagen glycation contributes to joint stiffness in cheiroarthropathy.
• Mechanisms for tendinopathy in diabetes may involve inflammation, apoptosis, and increased vascularity, potentially influenced by local fat pads.

Conclusions:

• Cheiroarthropathy management is primarily conservative, emphasizing occupational and hand therapy.
• The exact cause of tendinopathy in diabetes is unknown but multifactorial, involving metabolic and inflammatory pathways.
• Further research is needed to fully elucidate the pathogenesis and optimize treatment for these diabetes-related musculoskeletal conditions.