Osteoarthritis and Diabetes: Increasing Pain, Complications
As if life with osteoarthritis is not difficult enough, diabetes can make everything worse. Both type 1 and type 2 diabetes are related to frequently fluctuating and fragile blood sugar levels. On account of this instability, internal organs and other system wide functions do not operate at an optimum level. And when it comes to living with and treating osteoarthritis, diabetes exacerbates the pain and complicates the treatment.
Like other forms of arthritis, osteoarthritis is basically a condition that inflames the joint or joints. The swelling, heat and pain from an inflamed joint can be exacerbated by frequent fluctuations in the blood sugar levels. That’s why a basic principle of the anti-inflammatory diet is to control blood sugar levels by eating a low glycemic load diet. This concept is even more important to someone with both diabetes and osteoarthritis.
If and when the inflammation and pain in a joint becomes unbearable, a doctor might recommend a cortisone shot. This too is fraught with problems when the patient with arthritis also has diabetes. The steroids used in the injections will oftentimes spike the blood sugar levels in a diabetic for a short period of time. During this time, the blood sugar levels need to be monitored closely and the medications adjusted in order to prevent a Hyperglycemic Event.
These types of complications are to be expected in someone with diabetes because diabetes affects the whole body. Infections are more likely. Kidney failure is more likely. And prolonged recovery times from surgery are more likely. In fact, in a nationwide study, researchers found that in those who had either knee or hip replacement surgery, diabetics had a much higher risk of complications than non-diabetics. Another group of researchers concluded:
“Regardless of diabetes type, patients with uncontrolled diabetes mellitus exhibited significantly increased odds of surgical and systemic complications, higher mortality, and increased length of stay during the index hospitalization following lower extremity total joint arthroplasty.”
That’s right; people with uncontrolled diabetes that have a joint replaced are not only going to stay in the hospital longer, but they also are more likely to die. That’s serious.
The combination of osteoarthritis and diabetes is a serious problem and not to be glossed over. My advice to anyone dealing with diabetes and osteoarthritis is to eat a very low glycemic load diet, monitor the blood sugar levels regularly, aggressively use medications to keep the blood sugar levels controlled, and talk about the potentials for problems with your doctor before having a cortisone shot into a joint or an operation on a joint. Life with diabetes and osteoarthritis can be made easier if you take a very active role in your care.
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.