Up until recently, it was understood that some musculoskeletal conditions are more common in those who also have been diagnosed with type 1 diabetes, but it was not clear as to whether diabetes was having a ‘causal’ role or was merely ‘associated’ (with other factors in play).
However, at this year’s Diabetes UK Professional Conference (DUKPC), it was presented that a group of academics at the University of Exeter had, for the first time, shown that 4 musculoskeletal (MSK) disorders can manifest as a ‘direct complication’ of type 1. These are as follows:
- Frozen shoulder;
- Trigger finger (also known as stenosing tenosynovitis/stenosing tenovaginosis);
- Carpal tunnel syndrome (CTS); and
- Dupuytren’s contracture.
Type 1 diabetes, which is not to be mistaken with lifestyle-induced type 2, is an autoimmune disease which occurs when the body’s immune system attacks insulin-producing cells in the pancreas, thus raising blood sugar levels. It accounts for around 8% of the 3.9 million people in the UK who have been diagnosed with diabetes.[i]
As reported by the Evening Standard, the Exeter team arrived at their findings by reviewing genetic and health data, sourced from the UK Biobank and FinnGen (Finnish) databases.[ii]
From this, it was established that those with type 1 diabetes were more likely to develop a range of health complications.
They then applied a statistical technique, called ‘Mendelian randomisation’, to test causality.
What they came to realise was that type 1 diabetes ‘directly increased’ the risk of developing the 4 conditions listed above, which typically induce pain and reduce mobility in shoulders, hands, wrists and fingers. The same could not be said for joint-degenerating osteoarthritis.
Lead researcher, Dr. Harry Green, hopes that by having a better grasp of the causal role that type 1 disease (resulting from long-term high blood sugar levels) plays in the onset of MSK complications, a path will be paved for these complications to be recognised earlier in patients and in turn, more timely treatment and improved outcomes should follow.
It is ‘crucial’ that healthcare professionals and patients with type 1 are now made aware of these findings (alongside established complications, such as heart attacks, kidney failure and stroke), says Dr. Elizabeth Robertson, Director of Research at Diabetes UK.
Naturally, it is vital for professionals in the field of personal injury law to heed these findings too. In a hypothetical industrial disease claim, involving a construction worker/engineer with trigger finger, could it be that an entry of type 1 diabetes in the claimant’s medical records, in conjunction with an arguable breach defence, can bring (the prospect of) litigation to a conclusion in the employer’s/insurer’s favour.
[i] ‘Differences between type 1 and type 2 diabetes’ (Diabetes.org.uk) <https://www.diabetes.org.uk/diabetes-the-basics/differences-between-type-1-and-type-2-diabetes> accessed 22 April 2021.
[ii] Nina Massey, ‘Type 1 diabetes can cause musculoskeletal problems, study suggests’ (21 April 2021 Evening Standard) <https://www.standard.co.uk/news/uk/scientists-university-of-exeter-diabetes-uk-b930813.html> accessed 22 April 2021.