Ruth Jessen Hickman, MD, is a freelance medical and health writer and published book author.
Nearly half of all adults with type 2 diabetes also have arthritis, most often osteoarthritis. The two conditions are common and share some underlying risk factors, such as increased age and weight; both may involve inflammation in the body.
This article discusses type 2 diabetes and osteoarthritis, how they impact each other, treatment, and management.
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Both osteoarthritis and type 2 diabetes are common, particularly in older adults. Osteoarthritis affects roughly one-third of people over age 65, causing painful and stiff joints. Type 2 diabetes affects over 10% of American adults in this age group.
Although inflammation is not often associated with diabetes, evidence in the last decade has shown that excess inflammation can play a role in causing or worsening the condition.
Osteoarthritis is the gradual breakdown of cartilage and tissue. It’s considered degenerative arthritis and is not necessarily associated with inflammation. While it doesn’t cause as much inflammation as a condition like rheumatoid arthritis (RA), researchers have found that osteoarthritis does involve some joint inflammation.
In theory, specific inflammatory signaling molecules released into the blood could exacerbate joint symptoms in someone who has osteoarthritis and type 2 diabetes.
The lack of response to the hormone insulin in people with type 2 diabetes (insulin resistance) may also contribute to inflammation and damage cells that typically protect and maintain the joint.
The high blood sugar levels (hyperglycemia) associated with diabetes might also lead to the formation of compounds that irritate and damage the joints affected by osteoarthritis.
People with type 2 diabetes seem to have a slightly higher risk of osteoarthritis than those without the condition. This could be from shared underlying risks, such as having excess weight, increased age, lack of or inability to exercise regularly, increased inflammation, or others.
Some studies have found that people with osteoarthritis and type 2 diabetes may be more likely to need joint replacement surgery compared to people who don’t have type 2 diabetes. Having type 2 diabetes might also slightly increase the risk of complications after surgery—for example, you might be more likely to get an infection after surgery or need additional surgical procedures.
Having osteoarthritis might also indirectly increase complications in people with type 2 diabetes. For example, many people with osteoarthritis take non-steroidal anti-inflammatory drugs (NSAIDs) to help manage arthritis pain. These drugs may increase the risk of heart problems in people with diabetes, who are already at increased risk.
Exercise is crucial for treating and managing osteoarthritis and type 2 diabetes. It can help improve mobility and strength and may facilitate helpful weight loss, leading to better blood sugar management and decreased osteoarthritis pain.
However, physical exercise and mobility can be challenging for people who have these conditions. Over a quarter of adults with type 2 diabetes and osteoarthritis are somewhat limited in their daily activities because of their joint symptoms.
Activities like water aerobics or swimming may be less painful on joints than walking or jogging. Work with your healthcare provider to find an exercise routine that is achievable, safe, and effective for your personal goals.
Eating a nutritious diet is also important for keeping your blood sugar in a normal range. Losing weight may reduce the need for medications and help reduce osteoarthritis symptoms.
People with type 2 diabetes and osteoarthritis need to work closely with their healthcare providers to manage their medications.
Taking NSAIDs like Motrin (ibuprofen) for joint pain can increase the risk of kidney damage—a complication that a person with type 2 diabetes is already at a higher risk for. NSAIDs may also interact adversely with certain diabetes medications, including SGLT2 inhibitors such as Invokana (canagliflozin).
Similarly, while a corticosteroid injection into an arthritic joint may temporarily help relieve arthritic symptoms, it can also increase your blood sugar levels for several days. As a result, you might need to adjust your medications temporarily.
Be sure that all healthcare providers treating you are aware of all the medications you are taking, including all over-counter (OTC) medications, such as Advil or Tylenol.
Type 2 diabetes and osteoarthritis are common health conditions, so it's not surprising that some people have both. Type 2 diabetes may increase your risk of osteoarthritis partly because of shared underlying risk factors such as older age, increased weight, and possibly, inflammation. Having type 2 diabetes can also worsen your osteoarthritis symptoms.
Exercise and diet are essential parts of treatment for both type 2 diabetes and osteoarthritis. Talk with your healthcare provider to determine a diet and exercise plan that works for you. Tell them about all medications you're taking to minimize adverse interactions. By optimally managing your diabetes, you might be able to reduce your risk of severe osteoarthritis symptoms.
Having either type 2 diabetes or osteoarthritis can be challenging, but having both conditions can be even more so. Making lifestyle changes like eating a healthy diet and getting regular exercise can help you manage both conditions. Get support from your healthcare provider for making a treatment plan that works best for you.
No. Many people with diabetes never develop osteoarthritis, even in the later years of their life.
No. Osteoarthritis is a very common condition, especially in people over 65. Most people with osteoarthritis never get diabetes.
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Ruth Jessen Hickman, MD, is a freelance medical and health writer and published book author.
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