Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.

Question:

Is high blood sugar related to joint pain?

Answer:

No, there is no direct link between blood sugar level and joint pain.

A person who has untreated or poorly controlled diabetes may have high blood sugar. Significant variations in blood sugar can also occur over the course of a day. But these fluctuations do not cause joint pain. And low blood sugar (which may develop when a person with diabetes takes too much medication or skips a meal) has no clear effect on joint symptoms.

However, there is an indirect connection between blood sugar and joint pain. People with diabetes are at increased risk of tendonitis, bursitis, plantar fasciitis and other conditions that cause joint pain. There is even a syndrome (called the Syndrome of Limited Joint Mobility) associated with diabetes. With this syndrome, the joints, especially the finger joints, are stiff and have reduced range of motion. These problems are most common among people with long-standing diabetes that requires insulin treatment.

Although this is unproven, joint problems may be more common among people with poorly controlled diabetes than among those with well-controlled disease. Future research may prove that tight blood sugar control can prevent joint problems.