Diabetes arthritis and pain quick guidance. ANA and Diabetes

Introduction

Why did I choose diabetes arthritis? From my experience, and several hundred research papers, diabetes is a common cause of osteoarthritis. It is also a cause on its own self. Meaning even if the individual is not obese, they still get worse osteoarthritis. I commonly get referrals for patients with pain issues that stems from poorly controlled diabetes. Unfortunately, excessive availability of labs leads primary providers to order more testing despite the cause screaming diabetes.

I don’t mean to tell you that you cannot have Rheumatoid arthritis and diabetes arthritis at the same time. I am saying that if it is clear osteoarthritis from the history, no need to do random testing. I discussed autoimmune labs in another article. So let us delve and find if your issues could possibly be related to diabetes.

Diabetes arthritis is fast osteoarthritis

Diabetes arthritis, namely osteoarthritis, is made worse and faster with diabetes. As I mentioned above, even when researchers statistically removed the effect of weight, diabetes remained a factor of wear and tear arthritis- osteoarthritis. “But medical hermit! my fingers get stuck and my doc told me I have tendon issues”. You can name any tendon issue, probably I have seen it in Diabetic patients. Just some examples: trigger finger, tennis elbow, golfer’s elbow, rotator cuff tendonitis, and trochanteric bursitis.

Diabetes pain induced by nerve issues

What about the nerves? What nerve issues can diabetes cause? To answer this question, understand that poor diabetes control leads small vessels to malfunction and the supply to nerves gets affected. This could be large or smaller nerves (small fiber neuropathy). The latter, as described in prior articles, feels like whole hand or foot tingling and not specific spot. We call this description “gloves and stockings syndrome” which is a classical loss of sensation or cause of diabetes pain in the hands and feet.

Also, diabetic patients can get large nerve damage to the degree of whole limbs of part of limbs get numbness or weakness. A neurologist can do a nerve conduction test to evaluate large nerve but not small nerves (small fiber neuropathy). So, a nerve doctor can find carpal tunnel syndrome, ulnar nerve issues, peroneal nerve issues, and more. But keep in mind as diabetes can cause worse osteoarthritis in the spine, the nerves coming out of the spine might get pressured. At that point, an MRI for spine in the neck area or lower back areas might show the nerve pressure.

Now that we are talking nerves, let us talk autonomic nerve system. This is the nerve system that control blood vessels, sweating, blood pressure, and bowels- to name a few. Some docs might think you have Raynaud’s, which could be seen in other autoimmune disease, while in reality the nerves controlling your blood vessels has been affected and now your hands get red, purple, and white randomly and easily. The main difference that Raynaud’s only happens with the cold temperature while generally speaking diabetes color change could be random. Also, diabetes finger color changes typically involve the tips compared to classical Raynaud’s that involves the whole finger up to the base of the finger.

ANA and diabetes

Ok, you might be asking why am I talking about autoimmune lab ANA if I am talking diabetes. The simple answer that commonly diabetes patients have issues above but health care providers might still insist on sending autoimmune work up. As we learned previously, autoimmune labs are usually not a good test. Although previously we said that older age leads to higher chance of positive ANA, it seems diabetic patients have more positive ANA than general population. Also, positive ANA might possibly indicate worse diabetes mellitus. Let me says this: I do NOT by any means recommend sending ANA testing for diabetic patients. BUT if your ANA is positive, it might be related to poor control of diabetes.

Summary

In summary if you have diabetes and started having joint pains, please consider looking at how well controlled is your diabetes and other health issues. Looking for rare issues that causes pain is typically not advisable- unless specific character of pain occurs. Intensity of pain, or how bad is it, should NOT trigger autoimmune work up alone. There are more possible complications of diabetes but this article is not the proper place to discuss.