EC Paediatrics

Type 1 diabetes mellitus (T1DM) affects millions of people and is of significant public health concern. Unlike type 2 diabetes, T1DM is an organ specific autoimmune disease affecting mainly children and young adults, although it can occur at any age. Such affected patients require lifelong insulin therapy and careful meticulous management to prevent acute and chronic complications.

The incidence and prevalence rates of T1DM are increasing in most high-income countries except in females in Finland [7]. Worldwide increases in childhood T1DM were observed by Chen., et al. from 1965 to 2012 [4]. This increase in disease burden makes T1DM an important health challenge that needs utmost global attention focussing on prevention, management and care to reduce morbidity and mortality.

In T1DM, an irreversible autoimmune destruction of the pancreatic β cells results in loss insulin production. As a consequence, the ability of the body to control blood glucose is impaired, with resultant elevated blood glucose levels. Human Leukocyte antigen (HLA) association in type 1 diabetes mellitus has been documented, as has been reported in other autoimmune diseases (AID) which are organ-specific [6]. When T1DM is diagnosed, the pathophysiological processes have destroyed most of the pancreatic β cells. High blood glucose levels that ensue due to pancreatic insufficiency ultimately cause a wide array of organ-specific complications which impact significantly on a patient’s quality of life. These include cardiovascular, neurological, gastrointestinal, immunological and rheumatic and musculoskeletal system (RMD) complications, to mention a few.

In this review, we focus on the rheumatic and musculoskeletal complications of T1DM. These complications include diabetic cheiroarthropathy, adhesive capsulitis (AC), carpal tunnel syndrome (CTS), diabetic osteoarthropathy, diffuse idiopathic skeletal hyperostosis (DISH) inter alia. T1DM has been demonstrated in multiple studies to have a significant association with rheumatic conditions such as Juvenile Idiopathic Arthritis (JIA), Osteoporosis, Sjogren’s syndrome, Osteoarthritis and, not surprisingly, other autoimmune diseases such as hypothyroidism.

Keywords: T1DM; Type 1 Diabetes Mellitus; Rheumatic and Musculoskeletal Disorder (RMD); Osteoporosis; JIA; Diabetic Cheiroarthropathy; Osteoarthritis; Hypothyroidism; DISH; Children; Adolescent; Charcot’s Joint

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