From Glycemia to Grip: A Comprehensive Review of Musculoskeletal Complications in Diabetic Patients

Diabetes mellitus is a chronic metabolic disorder with well-established vascular complications. Its impact on the musculoskeletal (MSK) system is often underrecognized in clinical practice. MSK disorders contribute significantly to pain, functional limitations, and decreased quality of life in individuals with diabetes. However, they remain inadequately addressed in primary care settings. This narrative review aims to synthesize current evidence on the prevalence, assessment, pathophysiology, clinical features, and management of MSK complications in individuals with diabetes, with an emphasis on the role of primary care providers (PCPs) in early detection and management. A comprehensive literature search was conducted using PubMed, Google Scholar, and Scopus to identify peer-reviewed studies published between 2000 and 2025. Findings were organized thematically. MSK complications, including diabetic cheiroarthropathy, trigger finger, adhesive capsulitis, carpal tunnel syndrome (CTS), diffuse idiopathic skeletal hyperostosis (DISH), and Charcot joint, are significantly more prevalent in diabetic populations compared to non-diabetics. These conditions are driven by hyperglycemia-induced biochemical changes, chronic inflammation, and microvascular dysfunction. Primary care interventions encompass lifestyle modification, physical therapy, and pharmacologic management. These can help mitigate disability and improve patient outcomes. Despite the burden, diabetes-related MSK disorders are often overlooked due to time constraints, lack of awareness, and absence of standardized guidelines. Integrating MSK assessment into routine diabetes care is essential to reduce morbidity and preserve mobility in individuals with diabetes. PCPs play a central role in early identification and management of these conditions. Patient education, multidisciplinary collaboration, and future development of evidence-based screening protocols are critical in improving management of diabetes-related MSK complications.