User:Rochni/sandbox/Effect of Diabetes

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Healing

  • Obesity/Type II diabetes alters macrophage polarization resulting in a fibrotic tendon healing response[1]

Influence of Comorbidities

Diabetes is often accompanied by other medical conditions, some of which may influence tendon health on their own or in combination with the primary disease. For this reason, care must be taken when attributing an observation to diabetes; is it perhaps actually being caused or influenced by one of the below?

  • Obesity: a risk factor for both diabetes and tendon injury [2], an increased average load on the Achilles tendons due to obesity may exacerbate minor tears or increase damage accumulation in a given period of time.
  • Diabetic foot: infections, ulcers and joint degeneration (neuropathic arthropathy) resulting from diabetes can lead to altered gait patterns and thus abnormal tendon profiles on the Achilles tendons.

Other Collagen-Based Structures & Joints

Skin

  • Thermally-induced isometric contraction tension increases, as does the temperature involved in this process[3].
  • Stress at rupture is unaffected[4].

Shoulder capsule

  • Shoulder capsulitis is more prevalent in diabetic patients, and is also associated with age, duration of diabetes, autonomic neuropathy and a history of myocardial infarction [5] [6].
  • Periarthritis (frozen shoulder) - pain, stiffness and immobility in the shoulder - is significantly more prevalent amongst diabetics[7] [8].

Hand

  • Cheiroarthropathy (thickened skin and limited joint mobility of the hands and fingers) correlates to both presence of and duration of diabetes[9].
  • Permanently finger flexion[10].
  • Trigger finger[11].

Ankle

  • Diabetic patients more regularly present with passive ankle stiffness and a reduced range of motion in dorsiflexion[12].
  • Significant increases in hysteresis (i.e. energy absorption during gait cycle) and stiffness (both dorsiflexion and plantarflexion) due to diabetes[13].

Read More

  • Rosenbloom, Arlan L., and Janet H. Silverstein. "Connective tissue and joint disease in diabetes mellitus." Endocrinology and metabolism clinics of North America 25.2 (1996): 473-483.

References

  1. ↑ Ackerman, Jessica E., et al. "Obesity/Type II Diabetes Alters Macrophage Polarization Resulting in a Fibrotic Tendon Healing Response." bioRxiv (2017): 131607.
  2. ↑ Gaida, James E., et al. "Is adiposity an under‐recognized risk factor for tendinopathy? A systematic review." Arthritis Care & Research 61.6 (2009): 840-849.
  3. ↑ Yosha, S. R., et al. "Experimental diabetes mellitus and age-simulated changes in intact rat dermal collagen." Diabetes 32.8 (1983): 739-742.
  4. ↑ Yosha, S. R., et al. "Experimental diabetes mellitus and age-simulated changes in intact rat dermal collagen." Diabetes 32.8 (1983): 739-742.
  5. ↑ Arkkila, P. E., et al. "Shoulder capsulitis in type I and II diabetic patients: association with diabetic complications and related diseases." Annals of the rheumatic diseases 55.12 (1996): 907-914.
  6. ↑ Balci, Nilüfer, Mustafa Kemal Balci, and Serdar Tüzüner. "Shoulder adhesive capsulitis and shoulder range of motion in type II diabetes mellitus: association with diabetic complications." Journal of Diabetes and its Complications 13.3 (1999): 135-140.
  7. ↑ Bridgman, J. F. "Periarthritis of the shoulder and diabetes mellitus." Annals of the rheumatic diseases 31.1 (1972): 69.
  8. ↑ Aydeniz, A., S. Gursoy, and E. Guney. "Which musculoskeletal complications are most frequently seen in type 2 diabetes mellitus?." Journal of International Medical Research 36.3 (2008): 505-511.
  9. ↑ Aydeniz, A., S. Gursoy, and E. Guney. "Which musculoskeletal complications are most frequently seen in type 2 diabetes mellitus?." Journal of International Medical Research 36.3 (2008): 505-511.
  10. ↑ Aydeniz, A., S. Gursoy, and E. Guney. "Which musculoskeletal complications are most frequently seen in type 2 diabetes mellitus?." Journal of International Medical Research 36.3 (2008): 505-511.
  11. ↑ Aydeniz, A., S. Gursoy, and E. Guney. "Which musculoskeletal complications are most frequently seen in type 2 diabetes mellitus?." Journal of International Medical Research 36.3 (2008): 505-511.
  12. ↑ Rao, Smita R., et al. "Increased passive ankle stiffness and reduced dorsiflexion range of motion in individuals with diabetes mellitus." Foot & ankle international 27.8 (2006): 617-622.
  13. ↑ Trevino, Saul G., et al. "Use of a torque-range-of-motion device for objective differentiation of diabetic from normal feet in adults." Foot & ankle international 25.8 (2004): 561-567.
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