Musculoskeletal (MSK) complications are recognized comorbidities of diabetes mellitus and may contribute to reduced functional capacity and quality of life. In this cross-sectional study published in the Chronicle of Diabetes Research and Practice, 240 adults aged 18–60 years with diabetes were enrolled from outpatient and inpatient departments of a tertiary referral center. Clinical, laboratory, and radiological assessments were performed to evaluate MSK manifestations and their association with disease duration, glycemic control, and microvascular complications.

Microvascular complications included diabetic neuropathy (35.4%), retinopathy (17.9%), and albuminuria (29.2%). MSK manifestations included limited joint mobility (18.8%), frozen shoulder (13.3%), and osteoporosis (14.2%). Longer duration of diabetes was significantly associated with frozen shoulder (P=0.024), Charcot joint (P=0.016), and osteoporosis (P=0.001). Glycated hemoglobin levels did not show a significant association with MSK complications. Albuminuria and retinopathy were associated with carpal tunnel syndrome (odds ratio [OR] 1.23), frozen shoulder (OR 1.55), and diabetic muscle infarction (OR 5.09).

As a cross-sectional, single-center study, causal relationships cannot be inferred, and selection bias may limit generalizability. Limited macrovascular and renal function data were available, and subgroup analysis for type 1 diabetes (n=40) was underpowered.

MSK complications were common in this diabetic cohort and were associated with longer disease duration and microvascular involvement. Longitudinal, multicenter studies are needed to clarify temporal relationships and inform early detection strategies.