Diabetes at mga Kondisyon sa Itaas na Limbo Impormasyon

Ano ang nararamdaman mo

Maaaring mapansin mo ang sakit sa iyong balikat na parang galing sa malalim na bahagi. Ang sakit na ito ay maaaring senyales ng frozen shoulder, isang kondisyon kung saan ang kasukasuan ay nagiging matigas at masikip. Kung mayroon kang diabetes, mas madali na mabuo ang katigasan na ito. Sa katunayan, 37.5% ng mga taong may primary frozen shoulder ay may prediabetes. Maaaring makita ng iyong doktor na ang type 2 diabetes ay direktang sanhi ng katigasan na ito. Maaaring ramdam mo na ang iyong balikat ay unti-unting nakakulong, na nagpapahirap sa paggalaw.

Maaari ring maramdaman ng iyong mga kamay at pulso ang discomfort. Maaari kang maranasan ang biglaang matulis na sakit at pamamaga sa iyong kamay nang walang anumang pinsala. Maaaring parang carpal tunnel syndrome ang pakiramdam, ngunit maaari itong mangyari nang hiwalay dahil sa diabetes. Maaaring mapansin mo na mas malala ang iyong mga sintomas kaysa karaniwan. Ito ay dahil ang mas mataas na antas ng ilang mga protina sa lining ng iyong tendon ay nakakonekta sa mas malubhang nerve compression. Kung mayroon ka ring obesity, maaaring mas malakas ang pakiramdam ng mga sintomas na ito. Ang kombinasyon ng diabetes at sobrang timbang ay nagdaragdag sa panganib at lakas ng sakit sa kamay.

Maaaring magiging mahirap ang mga gawain sa araw-araw. Maaaring mahirapan kang umabot sa likod ng iyong likod upang isara ang bra o itabi ang damit. Ang mga simpleng galaw tulad ng pag-angat ng tasa o pag-ikot ng hawakan ng pinto ay maaaring masaktan. Karaniwang lumala ang sakit sa gabi, na nagpapahirap sa pagtulog sa iyong gilid. Maaaring makita mo na mas mabagal ang paggaling ng mga impeksyon sa iyong kamay o mas malala ang pakiramdam kung hindi maayos ang kontrol sa iyong asukal sa dugo. Mahalagang panatilihin ang iyong diabetes sa ilalim ng kontrol. Ang regular na ehersisyo para sa iyong mga upper limbs ay makakatulong upang maantala ang pagkasira ng tendon. Sa pamamagitan ng pagmamana sa iyong mga antas ng asukal sa dugo, makakatulong kang protektahan ang iyong mga tendon at bawasan ang lakas ng sakit na nararamdaman mo araw-araw.

Ano ang nangyayari talaga

Kapag mayroon kang diabetes, ang mataas na antas ng asukal sa dugo ay maaaring magbago sa paraan ng paggana ng mga tisyu ng iyong katawan. Ito ay lumilikha ng malagkit na mga protina ng asukal na nagtitipon sa iyong mga tendon at kasukasuan. Isipin ang isang tendon na parang matibay na lubid na nag-uugnay ng iyong mga kalamnan sa iyong mga buto. Sa diabetes, maaaring maging matigas at mahina ang lubid na ito. Maaaring hindi mo agad nararamdaman ang sakit, ngunit nagsisimula nang magbago ang tisyu. Ang maagang pagkasira dahil sa paggamit ay maaaring mangyari kahit wala ka pang anumang sintomas.

Ang iyong balikat ay nakabalot ng isang mahigpit na manggas na tinatawag na joint capsule. Sa diabetes, maaaring maging pamamaga at makapal ang manggas na ito. Ititigil ito at mahigpit na aakapin ang kasukasuan. Ito ay karaniwang tinatawag na frozen shoulder. Nagiging mahirap at masakit ang paggalaw ng iyong braso. Ipakita ng mga pananaliksik na 37.5% ng mga taong may kondisyong ito ay may prediabetes. May direktang papel ang iyong mga antas ng asukal sa dugo sa paglikha ng katigpang ito.

Sa iyong pulso, ang parehong proseso ay maaaring pindutin ang nerbiyos na kontrolado ang iyong kamay. Ito ay carpal tunnel syndrome. Ang pamamaga at pagkapal ay nagpapindot sa nerbiyos, na nagdudulot ng sakit o pamamanhid. Mas mataas ang risk na ito kung mayroon ka ring obesity. Ang pagkakaroon ng parehong diabetes at obesity ay nagdaragdag sa problema, na nagpapataas ng posibilidad na makakuha ka ng kondisyong ito.

Minsan, biglang mababagsak ang mga kalamnan sa iyong kamay o braso nang walang anumang pinsala. Ito ay nagdudulot ng matinding sakit at pamamaga. Maaaring mukhang malubhang impeksyon o saradong ugat ng dugo, ngunit ito ay direktang resulta ng diabetes. Titingnan ng iyong doktor nang maigi ang mga senyales na ito upang matukoy ang tamang sanhi.

Ang mahinang kontrol sa iyong asukal sa dugo ay nagpapahirap din sa paglaban sa mga impeksyon. Kung makakuha ka ng putol o impeksyon sa iyong kamay, maaaring maging mas malala ito kung mataas ang iyong mga antas ng glucose. Ito ang dahilan kung bakit napakahalaga ng pagpapanatili ng iyong diabetes sa ilalim ng kontrol. Tumutulong ito upang protektahan ang iyong mga tendon, kasukasuan, at nerbiyos mula sa mga tahimik na pagbabagong ito.

Mga maitutulong namin dito

Ang pamamahala ng iyong mga sintomas ay nagsisimula sa pang-araw-araw na mga gawi at banayad na paggalaw. Kung mayroon kang diyabetes, ang pagpapanatili ng matatag na antas ng asukal sa dugo ay isa sa pinakamahalagang hakbang na maaari mong gawin. Ang aktibong kontrol sa iyong diyabetes at regular na mga ehersisyo sa itaas na bahagi ng katawan ay maaaring makatulong na mapabagal ang pagkasira ng mga mahahalagang tendon sa iyong balikat, kahit wala pa man ang sakit.

Para sa mga kondisyon tulad ng frozen shoulder, maaaring irekomenda ng iyong doktor ang partikular na pisyoterapiya upang mabawi ang paggalaw. Kung mararamdaman mo ang biglaang sakit at pamamaga sa iyong kamay nang walang pinsala, agad mong ipaalam sa iyong doktor. Maaaring ito ay isang bihirang kondisyon na tinatawag na spontaneous diabetic myonecrosis. Ang maagang pagkuha ng tamang diagnosis ay tumutulong na maiwasan ang pagkalito sa ibang seryosong isyu tulad ng impeksyon o mga problema sa daloy ng dugo.

Ang medikal na pamamahala ay nakatuon sa pagbawas ng sakit at pamamaga. Maaaring magreseta ang iyong doktor ng mga anti-inflammatory na gamot upang makatulong sa iyo na gumalaw nang mas komportable. Sa ilang kaso, maaaring humingi ang iyong doktor ng tulong mula sa isang endocrinologist (espesyalista sa hormone) upang matulungan kang mas mahusay na pamahalaan ang iyong asukal sa dugo pagkatapos ng operasyon. Ang mahigpit na kontrol sa iyong asukal sa dugo sa unang 3 hanggang 6 buwan pagkatapos ng rotator cuff repair ay nauugnay sa mas magandang mga rate ng paggaling.

Kung pinag-iisipan mo ang mga prosedura tulad ng superior capsular reconstruction, alamin na ang tagumpay ay pinakamalapit na mangyari kung ang iyong diyabetes ay mahigpit na kontrolado. Maaaring hindi ito resulta na aplikable sa lahat ng may diyabetes. Ang mga bagong gamot sa diyabetes, tulad ng SGLT2 inhibitors, ay nagpapakita ng pangako para sa kalusugan ng tendon, ngunit limitado pa rin ang de-kalidad na ebidensya. Para sa carpal tunnel release, ang paggamit ng semaglutide bago ang operasyon ay hindi binabawasan ang mga komplikasyon o ang pangangailangan para sa reoperasyon sa loob ng dalawang taon.

Kung ang mga sintomas ay seryoso at hindi gumagaling sa pamamagitan ng self-care at gamot, maaaring irefer ang iyong doktor para sa espesyalistang pagsusuri. Para sa frozen shoulder, ang manipulation under anesthesia ay isang opsyon, bagama't maaaring makaapekto ang mas matanda na edad at diyabetes sa resulta. Para sa carpal tunnel syndrome, epektibo ang arthroscopic release kung ito ay ginawa nang maaga o huli.

Ang mga impeksyon sa kamay ay nangangailangan ng maingat na pag-aalaga. Ang diyabetes at sakit sa bato ay nagpapataas ng panganib ng pagkabigo sa paggamot para sa mga impeksyon sa balat tulad ng cellulitis. Habang ang karamihan sa mga impeksyon sa kamay ng mga may diyabetes ay maaaring gamutin bilang outpatient, ang iyong doktor ang magdesisyon kung kailangan mo ng hospital care batay sa iyong pangkalahatang kalusugan. Sa panahon ng pandemya, ang mga impeksyon sa kamay ng mga may diyabetes ay madalas na mas seryoso dahil sa mahinang kontrol sa asukal sa dugo. Laging iulat sa iyong care team ang mga senyales ng impeksyon, tulad ng pagtaas ng pamumula, init, o lagnat, sa pinakamaagang pagkakataon.

Ano ang inaasahan

Ang iyong prognosis ay nakadepende sa malaking bahagi sa kung gaano ka-epektibo ang iyong pamamahala sa antas ng asukal sa dugo. Para sa mga kondisyon tulad ng frozen shoulder o rotator cuff tears, ang mahigpit na kontrol ng diyabetes sa unang 3 hanggang 6 buwan pagkatapos ng operasyon ay nauugnay sa mas magandang rate ng paggaling. Kung mayroon kang type 2 diabetes, ang pagpapanatili ng aktibong kondisyon at regular na ehersisyo ng iyong mga itaas na ekstremitas ay maaaring makatulong na mapabagal ang pagkasira ng mga tendon ng iyong balikat, kahit bago pa lumabas ang mga sintomas.

Kung ikaw ay nag-aalok ng operasyon, tulad ng rotator cuff repair o carpal tunnel release, maaaring hingin ng iyong doktor na makipagtulungan ka sa isang endocrinologist upang i-optimize ang iyong asukal sa dugo bago ang prosedura. Habang ang mga antas ng asukal sa dugo bago ang operasyon ay hindi nagpapahiwatig ng pagkabigo ng operasyon para sa mga rotator cuff repairs, ang mahinang kontrol ay maaaring magdagdag ng panganib ng mga komplikasyon. Halimbawa, ang mga impeksyon sa kamay sa mga taong may diyabetes ay maaaring maging mas malala kung hindi maayos ang pamamahala ng asukal sa dugo. Sa ilang kaso, maaaring kailanganin nito ang hospital admission imbes na outpatient treatment.

Ang paggaling ay nag-iiba-iba depende sa indibidwal. Para sa frozen shoulder, ang mas matanda na edad at diyabetes ay maaaring gawing mas hindi epektibo ang ilang non-surgical treatments. Gayunpaman, ang surgical release para sa carpal tunnel syndrome ay nagpapakita ng katulad na mga resulta kung ito ay isasagawa nang maaga o maaga pa lang. Hindi mo dapat inaasahan na ang preoperative na paggamit ng semaglutide ay magpapababa ng mga short-term complications o long-term reoperation risks para sa carpal tunnel surgery.

Kung walang gamot, maaaring manatili o lumala ang mga sintomas. Ang spontaneous diabetic myonecrosis, isang bihirang kondisyon na nagdudulot ng akutong sakit at pamamaga sa kamay, ay nangangailangan ng maingat na diagnosis upang maiwasan ang pagkalito sa ibang mga isyu. Karamihan sa mga impeksyon sa kamay na dulot ng diyabetes ay maaaring matagumpay na gamutin bilang outpatient, ngunit ang iyong mga comorbidities ay makakaapekto sa desisyong ito.

Sa kabuuan, ang iyong aktibong pakikilahok sa pamamahala ng diyabetes ang pinakamahalagang salik na maaari mong kontrolin. Ito ay nakakaapekto sa paggaling, panganib ng impeksyon, at tagumpay ng parehong non-surgical at surgical interventions. Ang iyong doktor ay magtatakda ng iyong plano ayon sa iyong partikular na health profile, ngunit ang pagpapanatili ng mahusay na glycemic control ay nananatiling pundasyon ng iyong paggaling.

Kailan pumunta sa doktor

Pumunta sa iyong GP (General Practitioner) kung mayroon kang sakit sa balikat, dahil maaari itong magpahiwatig ng frozen shoulder. Humingi ng review mula sa isang espesyalista kung mararamdaman mo ang biglaang matinding sakit at pamamaga sa iyong kamay nang walang pinsala. Maaaring ito ay spontaneous diabetic myonecrosis. Humingi ng urgent care kung mayroon kang impeksyon sa kamay na lumalala, lalo na kung hindi maayos ang iyong blood sugar. Ang mahinang glycaemic control ay maaaring magpalala ng impeksyon. Pumunta din sa doktor kung mayroon kang patuloy na sakit o pamamanhid sa kamay, na maaaring magpahiwatig ng carpal tunnel syndrome. Ang diabetes ay maaaring gawing mas malala ang mga sintomas na ito. Huwag balewalain ang kahinaan o kawalan ng katatagan sa iyong mga upper limbs. Ang maagang assessment ay tumutulong sa pamamahala ng degeneration at pumipigil sa mga komplikasyon.

Evidence & references

Overview

Active control of diabetes and regular upper limb exercise may help delay degeneration of the supraspinatus tendon in asymptomatic type II diabetes mellitus patients [1].
Shoulder pain in people with diabetes could be indicative of frozen shoulder [2].
Clinicians should consider spontaneous diabetic myonecrosis in diabetic patients with atraumatic acute-onset pain and swelling in the hand to avoid confusion with other inflammatory, infectious, or vascular conditions [3].
The incidence and severity of diabetic hand infection presentations during the COVID-19 pandemic showed increased severity linked to poor glycaemic control [5].
Renal disease and diabetes increase the risk of failed outpatient management of cellulitic hand infections [6].
Most patients with cellulitic hand infections can undergo successful treatment as outpatients despite the increased risk associated with renal disease and diabetes [6].
The prevalence of prediabetes is 37.5% in patients with primary frozen shoulder [8].
Advanced glycation end products (AGEs) and RAGE expression in flexor tendon synovium are associated with the development of carpal tunnel syndrome in diabetic patients [10].
Monitoring HbA1c levels before elective surgery is important to improve outcomes in diabetic patients with carpal tunnel syndrome [10].
Obesity may possess a similar or more powerful relationship with carpal tunnel syndrome than diabetes alone, even without diabetes mellitus [11].
Comorbidity of obesity and diabetes suggests an additive effect on increased carpal tunnel syndrome prevalence [11].

Background & Causes

Early degeneration of the supraspinatus tendon is detectable via shear wave elastography in asymptomatic patients with type II diabetes mellitus [1].
Shoulder pain in people with diabetes may be indicative of frozen shoulder [2].
Spontaneous diabetic myonecrosis can present as acute carpal tunnel syndrome, manifesting as atraumatic acute-onset pain and swelling in the hand [3].
Poor glycaemic control is linked to increased severity of hand infections in diabetic patients [5].
Older age and the presence of diabetes mellitus are negative prognostic factors for shoulder manipulation under ultrasound-guided cervical nerve root block for frozen shoulder [7].
The prevalence of prediabetes is 37.5% in patients with primary idiopathic frozen shoulder [8].
Higher RAGE expression is observed in the flexor tendon synovium of diabetic patients with more severe carpal tunnel syndrome [9].
Advanced glycation end products (AGEs) and RAGE expression play a role in the development of carpal tunnel syndrome in diabetic patients [10].
Obesity possesses a similar or more powerful relationship with carpal tunnel syndrome than diabetes alone, and comorbidity of obesity and diabetes suggests an additive effect on increased carpal tunnel syndrome prevalence [11].
Type 2 diabetes and fasting glycemic traits are causal factors of frozen shoulder [12].
Increased stiffness and tone in extrinsic foot muscles, Achilles tendon, and plantar fascia may contribute to abnormal foot loading patterns, potentially increasing the risk of ulcer recurrence in patients with a history of diabetic foot ulcers [18].
Matrix metalloproteinase-1 and matrix metalloproteinase-9 are highly expressed in the joint capsule of diabetic frozen shoulder [20].
Altered molecular processes, including oxidative stress response and extracellular matrix organization, may contribute to tendon degeneration and impaired healing in diabetes patients [23].
The HMGB1/RAGE/β-catenin axis mediates aberrant osteogenic-tenogenic differentiation imbalance of tendon stem/progenitor cells in diabetic tendinopathy [24].

Symptoms & Presentation

Early degeneration of the supraspinatus tendon can occur in asymptomatic patients with type II diabetes mellitus [1].
Shoulder pain in people with diabetes may be indicative of frozen shoulder [2].
Spontaneous diabetic myonecrosis can present as acute carpal tunnel syndrome, characterized by atraumatic acute-onset pain and swelling in the hand [3].
Diabetic patients with hand infections may present with increased severity of infection linked to poor glycaemic control [5].
The prevalence of prediabetes is 37.5% in patients with primary idiopathic frozen shoulder [8].
Higher RAGE expression in flexor tendon synovium is associated with more severe carpal tunnel syndrome in patients with diabetes [9].
Obesity, even without diabetes mellitus, has a similar or more powerful relationship with carpal tunnel syndrome than diabetes alone, and the comorbidity of obesity and diabetes suggests an additive effect on increased carpal tunnel syndrome prevalence [11].
Type 2 diabetes and fasting glycemic traits are causal factors of frozen shoulder [12].
Diabetic carpal tunnel syndrome presents with more profound electrophysiological abnormalities compared to non-diabetic cases [15].

Management

Active control of diabetes and regular upper limb exercise may help delay supraspinatus tendon degeneration in asymptomatic type II diabetes mellitus patients [1].
Clinicians should remain alert that shoulder pain in people with diabetes could be indicative of frozen shoulder [2].
Clinicians should consider spontaneous diabetic myonecrosis in diabetic patients with atraumatic acute-onset pain and swelling in the hand to avoid confusion with other inflammatory, infectious, or vascular conditions [3].
The efficacy of low-level laser therapy versus muscle energy technique for frozen shoulder related to diabetes requires further evidence from randomized controlled trials to guide clinical practice [4].
Hand infections in diabetic patients during the COVID-19 pandemic were associated with increased severity linked to poor glycaemic control [5].
Renal disease and diabetes increase the risk of failed outpatient management of cellulitic hand infections, influencing consideration for inpatient therapy, although most patients can undergo successful treatment as outpatients [6].
Older age and the presence of diabetes mellitus are negative prognostic factors for shoulder manipulation under ultrasound-guided cervical nerve root block for frozen shoulder [7].
Preoperative semaglutide use was not associated with a reduction in 90-day complications or 2-year reoperation-free survival in patients with type II diabetes mellitus undergoing carpal tunnel release [13].
Strict glycemic control in the first 3 to 6 months after arthroscopic rotator cuff repair is a modifiable risk factor associated with better healing rates [14].
Surgeons should consider engaging endocrinology colleagues to improve postoperative glycemic control in select patients undergoing rotator cuff repair [14].
There were no significant differences in outcomes between early and delayed arthroscopic capsular release in patients with a history of diabetes mellitus [16].
Targeted inhibition of MCP-1 or its receptor CCR2 ameliorates mechanical allodynia, restores locomotor function, and enhances biomechanical properties in diabetic murine models of rotator cuff tear [19].
Preclinical and observational studies provide preliminary support for the therapeutic benefits of SGLT2 inhibitors in diabetic rotator cuff disease, although high-quality randomized clinical trials are lacking [21].

Key Considerations

Active control of diabetes and regular upper limb exercise may help delay degeneration of supraspinatus tendons in asymptomatic type II diabetes mellitus patients [1].
Shoulder pain in people with diabetes could be indicative of frozen shoulder [2].
Clinicians should consider spontaneous diabetic myonecrosis in diabetic patients with atraumatic acute-onset pain and swelling in the hand to avoid confusion with other inflammatory, infectious, or vascular conditions [3].
The findings of a study comparing low-level laser therapy versus muscle energy technique may provide evidence on the efficacy of these interventions and guide clinical practice for frozen shoulder related to diabetes [4].
There was an increased severity of hand infections in treated patients during the COVID-19 pandemic, linked to poor glycaemic control [5].
Renal disease and diabetes increase the risk of failed outpatient management of cellulitic hand infections, influencing consideration for inpatient therapy [6].
Older age and the presence of diabetes mellitus are negative prognostic factors for shoulder manipulation under ultrasound-guided cervical nerve root block for frozen shoulder [7].
The prevalence of prediabetes is 37.5% in patients with primary frozen shoulder [8].
Among patients with diabetes who had carpal tunnel syndrome, higher RAGE expression was observed in those with more severe disease, suggesting RAGE-mediated pathways may play a role in the pathophysiology of CTS in patients with diabetes [9].
Preoperative semaglutide use was not associated with a reduction in 90-day complications or 2-year reoperation-free survival in patients with type II diabetes mellitus undergoing carpal tunnel release [13].
Diabetic carpal tunnel syndrome had more profound electrophysiological abnormalities compared to non-diabetic cases [15].
There were no significant differences in outcomes between early and delayed arthroscopic release in patients with a history of diabetes mellitus undergoing arthroscopic capsular release for adhesive capsulitis [16].
In patients with diabetes mellitus, preoperative HbA1c is not a predictive factor for surgical failure requiring reoperation following arthroscopic rotator cuff repair [17].
Understanding perioperative management guidelines for diabetes is essential for hand surgeons to prevent unexpected day of surgery cancellations [22].

Key Evidence

[L3] Active control of the condition of diabetes patients and regular upper limb exercise might help delay the degeneration of supraspinatus tendons. [1] (10.1186/s12891-025-08864-w)
[L2] Clinicians should remain alert that shoulder pain in people with diabetes could be indicative of a frozen shoulder. [2] (10.1186/s12891-025-08672-2)
[L4] Clinicians should consider this diagnosis in diabetic patients with atraumatic acute-onset pain and swelling in the hand to avoid confusion with other inflammatory, infectious, or vascular conditions. [3] (10.1016/j.jhsg.2021.10.006)
[L2] The findings of the study may provide evidence on the efficacy of these interventions and most likely, the optimal treatment approach for frozen shoulder related to diabetes, which may guide clinical practice. [4] (10.1186/s13018-024-04735-7)
[L4] While fewer patients attended the service during the pandemic, there was an increased severity of hand infections in those treated, linked to poor glycaemic control. [5] (10.1177/17531934231196026)
[L3] These comorbidities should influence consideration for inpatient therapy though most patients can undergo successful treatment as outpatients. [6] (10.1186/s13018-023-03911-5)
[L3] Older age and the presence of diabetes mellitus are negative prognostic factors for shoulder manipulation under ultrasound-guided cervical nerve root block. [7] (10.1016/j.jseint.2024.11.022)
[L4] The prevalence of prediabetes is 37.5% in patients with primary frozen shoulder. [8] (10.1016/j.jseint.2023.08.017)
[L2] Among patients with diabetes who had CTS, higher RAGE expression was observed in those with more severe disease, suggesting that RAGE-mediated pathways may play a role in the pathophysiology of CTS in patients with diabetes. [9] (10.1097/corr.0000000000003800)
[Paper] This CORR Insights commentary highlights the role of advanced glycation end products (AGEs) and RAGE expression in the development of carpal tunnel syndrome in diabetic patients, emphasizing the importance of monitoring HbA1c levels before elective surgery to improve outcomes. [10] (10.1097/corr.0000000000003820)
[L2] Obesity even without diabetes mellitus may possess a similar or more powerful relationship with carpal tunnel syndrome than diabetes alone, and comorbidity of obesity and diabetes suggests an additive effect on increased carpal tunnel syndrome prevalence. [11] (10.1016/j.jhsg.2025.01.016)
[L1] This study supports a genetic causal relationship between type 2 diabetes and fasting glucose and frozen shoulder. [12] (10.1016/j.jse.2023.08.006)
[L3] Preoperative semaglutide use was not associated with a reduction in 90-day complications or 2-year reoperation-free survival in patients with type II diabetes mellitus undergoing carpal tunnel release. [13] (10.1016/j.jhsa.2025.09.003)
[L5] Strict glycemic control in the first 3 to 6 months after arthroscopic rotator cuff repair is a modifiable risk factor associated with better healing rates, and surgeons should consider engaging endocrinology colleagues to improve postoperative glycemic control in select patients. [14] (10.1016/j.arthro.2022.09.017)
[L4] Diabetic CTS had more profound electrophysiological abnormalities. [15] (10.1186/s12891-023-06881-1)
[L3] There were no significant differences in outcomes between early and delayed arthroscopic release in patients with a history of diabetes mellitus. [16] (10.1016/j.jseint.2023.06.007)
[L3] In patients with diabetes mellitus, preoperative HbA1c is not a predictive factor for surgical failure requiring reoperation. [17] (10.1016/j.jse.2023.06.034)
[L3] The increased stiffness and tone in these structures may contribute to abnormal foot loading patterns, potentially increasing the risk of ulcer recurrence. [18] (10.1186/s12891-025-08791-w)
[L4] Targeted inhibition of MCP-1 or its receptor CCR2 ameliorates mechanical allodynia, restores locomotor function, and enhances biomechanical properties in diabetic murine models. [19] (10.1016/j.jse.2026.05.025)
[L4] The findings of this study demonstrate the potential involvement of MMP-1 and 9 in the pathophysiology of diabetic FS. [20] (10.1016/j.jse.2024.03.062)
[L4] Preclinical and observational studies provide preliminary support for the therapeutic benefits of SGLT2 inhibitors in diabetic rotator cuff disease, although high-quality randomized clinical trials are lacking. [21] (10.5397/cise.2024.00969)
[L5] Understanding these perioperative management guidelines is essential for hand surgeons to prevent unexpected day of surgery cancellations. [22] (10.1016/j.jhsa.2024.05.018)
[L5] Bioinformatic analyses suggested several altered molecular processes, including oxidative stress response and extracellular matrix organization, may contribute to tendon degeneration and impaired healing in diabetes patients. [23] (10.1016/j.jse.2025.07.012)
[L5] The findings revealed the critical role of the HMGB1/RAGE/β-catenin axis in the differentiation imbalance of TSPCs and diabetic tendinopathy, highlighting a novel essential mechanism involved in the pathogenesis of diabetic tendinopathy and providing a promising therapeutic target and approach for diabetic tendinopathy. [24] (10.1186/s13018-025-06572-8)

References

[1] Shear wave elastography of the supraspinatus tendon with early degeneration in asymptomatic type II diabetes mellitus patients: a multicenter study. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08864-w [2] Type 2 diabetes, metabolic health, and the development of frozen shoulder: a cohort study in UK electronic health records. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08672-2 [3] Spontaneous Diabetic Myonecrosis Presenting as Acute Carpal Tunnel Syndrome. Journal of Hand Surgery Global Online. 2022. DOI: 10.1016/j.jhsg.2021.10.006 [4] Comparative effectiveness of low-level laser therapy versus muscle energy technique among diabetic patients with frozen shoulder: a study protocol for a parallel group randomised controlled trial. Journal of Orthopaedic Surgery and Research. 2024. DOI: 10.1186/s13018-024-04735-7 [5] The incidence and severity of diabetic hand infection presentations during the COVID-19 pandemic. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231196026 [6] Renal disease and diabetes increase the risk of failed outpatient management of cellulitic hand infections: a retrospective cohort study. Journal of Orthopaedic Surgery and Research. 2023. DOI: 10.1186/s13018-023-03911-5 [7] Older age and diabetes mellitus are negative prognostic factors for shoulder manipulation under ultrasound-guided cervical nerve root block for frozen shoulder: a retrospective cohort study. JSES International. 2025. DOI: 10.1016/j.jseint.2024.11.022 [8] Prevalence of prediabetes in patients with idiopathic frozen shoulder: a prospective study. JSES International. 2024. DOI: 10.1016/j.jseint.2023.08.017 [9] Is RAGE Expression in Flexor Tendon Synovium Associated With Carpal Tunnel Syndrome in Patients With Diabetes?. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003800 [10] CORR Insights®: Is RAGE Expression in Flexor Tendon Synovium Associated With Carpal Tunnel Syndrome in Patients With Diabetes?. Clinical Orthopaedics & Related Research. 2026. DOI: 10.1097/corr.0000000000003820 [11] Obesity as a Risk Factor for Carpal Tunnel Syndrome Independent of Diabetes Mellitus: A Nationwide Study. Journal of Hand Surgery Global Online. 2025. DOI: 10.1016/j.jhsg.2025.01.016 [12] Type 2 diabetes and fasting glycemic traits are causal factors of frozen shoulder: a 2-sample Mendelian randomization analysis. Journal of Shoulder and Elbow Surgery. 2024. DOI: 10.1016/j.jse.2023.08.006 [13] Endoscopic and Open Carpal Tunnel Release in Patients With Type II Diabetes Mellitus: Influence of Preoperative Semaglutide Use on Postoperative Outcomes. The Journal of Hand Surgery. 2025. 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