Musculoskeletal disorders (MSDs) refer to any compressive or non-traumatic disorder as well as to the personal history of stress fractures. MSDs are a known complication of type 1 diabetes mellitus (T1DM) [1]. Several MSDs are associated with T1DM, such as adhesive capsulitis (frozen shoulder), tendinitis, carpal tunnel syndrome, cheiroarthropathy and Dupuytren’s disease (DD) [2,3].

MSDs can impact the quality of life (QoL) of people living with T1DM (PwT1DM), as acts such as inserting a glucose sensor or using an insulin pen can be more challenging with limited mobility [4]. It is crucial to address MSDs as soon as they appear because they can lead to significant disability and chronic pain if untreated [5,6].

The pathogenesis of MSDs is different for each complication. Tendinopathy is associated with the accumulation of advanced glycation end products (AGEs) in type 1 and type 2 diabetes [7,8]. The increased risk of stress fractures in T1DM could be explained by more frequent falls due to hypoglycemia or treatment with hypertensive agents and there is strong evidence that the main culprit is a defect in osteoblast activity and differentiation together with an accumulation of AGEs and a role of other complications such as neuropathy [9]. Entrapment syndromes are commonly attributed to abnormal glucose levels, affecting all peripheral nerves [10] and tendons [11].

Previous studies have investigated the prevalence of MSDs in T1DM. In the Diabetes Control and Complications Trial cohort (mean age 52 years), 66% of participants had at least one MSD and were positively associated with age, diabetes duration, sex, HbA1c, neuropathy and retinopathy [1,11]. Other studies reported an incidence of 29-53% for MSDs with an association with other diabetes complications for populations of mean age 40-52 years [5,12,13], and higher levels of HbA1c [1].

Although these previous studies have analyzed associations with demographics, body mass index (BMI), HbA1c, and some diabetes complications, there is a gap in our understanding of the role of other variables such as lifestyle, glucose profile parameters, social vulnerability, and treatments.

The main objective of this study was to identify the main factors associated with MSDs. Secondary objectives included the consequences of MSDs on psychological and physical QoL.