Indian Study Finds 43 Percent Higher Osteoarthritis Risk in Patients with Type 2 Diabetes

Analyzing data from multiple systematic reviews and meta-analyses involving over 26,000 OA patients, researchers found that those with T2D had a 43% higher risk of developing OA compared to non-diabetic individuals (OR = 1.43). The association remained even after adjusting for factors such as age, sex, and obesity, suggesting T2D may independently contribute to OA development.

The study highlights potential mechanisms behind this link, including chronic hyperglycemia leading to the accumulation of advanced glycation end products (AGEs), which accelerate cartilage degradation and joint damage. Systemic inflammation, insulin resistance, and altered lipid metabolism in T2D may further exacerbate joint deterioration. Additionally, obesity and biomechanical factors like altered gait patterns place extra stress on weight-bearing joints such as the knees and hips.

Obesity is a well-established risk factor for both T2D and OA, and its role as a confounder in the relationship between these two conditions is significant. While the association between T2D and OA persisted after adjusting for BMI, the strength of the association was somewhat attenuated, indicating that obesity plays a substantial role but does not entirely explain the link. Recognizing the need to explore this relationship further, Dr. Raju Vaishya, Department of Orthopaedics, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India, and colleagues conducted an umbrella review of systematic reviews and meta-analyses to explore the potential bidirectional relationship between type 2 diabetes and osteoarthritis.

Key Findings:

• Four systematic reviews were analyzed, including three meta-analyses.
• Data from 26,209 osteoarthritis patients were considered, including 3,530 with type 2 diabetes and 22,679 without diabetes.
• Patients with type 2 diabetes had a significantly higher risk of developing osteoarthritis (OR = 1.43).
• The association remained significant even after adjusting for age, sex, and obesity (pooled adjusted OR = 1.22).

Dr. Vaishya and colleagues highlight the crucial clinical implications of their findings, urging physicians to actively screen diabetic patients for osteoarthritis (OA), especially those with joint pain or mobility issues. Early diagnosis and timely intervention could help slow disease progression and improve patient outcomes. Effective management through weight control, glycemic regulation, and inflammation reduction may benefit both conditions.

"With the rising prevalence of T2D and OA, particularly in low- and middle-income countries, preventive strategies are essential. Awareness campaigns and integrated healthcare approaches addressing metabolic and musculoskeletal health could help reduce the burden of these diseases," the authors noted.

They further emphasized the need for research to clarify the causal pathways linking T2D and OA. "High-quality longitudinal studies controlling for confounding factors, particularly obesity, are necessary. Future research should also explore targeted therapies like anti-inflammatory or AGE-modulating treatments to lower OA risk in diabetic patients," they added.

Concluding, the researchers emphasized the importance of a multidisciplinary approach. "Early detection and integrated care are key to improving the quality of life for individuals affected by these chronic conditions," they affirmed.

Reference:

1. Vaishya R, Misra A, Patralekh MK, Kalra P, Vaish A, Migliorini F. Association of Type 2 Diabetes and Osteoarthritis : an umbrella review of systematic reviews and meta-analyses. Eur J Orthop Surg Traumatol 35, 111 (2025). https://doi.org/10.1007/s00590-025-04231-6