Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Sustained elevation of blood glucose levels leads to a wide spectrum of systemic complications that significantly contribute to morbidity and reduced quality of life¹. Chronic hyperglycemia adversely affects cellular function through multiple mechanisms, including non-enzymatic glycation of proteins, increased oxidative stress, and activation of inflammatory pathways.² These processes result in structural and functional alterations of connective tissue by modifying extracellular matrix components such as collagen, proteoglycans, and elastin, ultimately leading to tissue stiffness, reduced elasticity, and impaired repair mechanisms. Such pathological changes form the basis for many long-term complications observed in individuals with diabetes.^3,4While vascular complications of diabetes, including retinopathy, nephropathy, neuropathy, and macrovascular disease, have been extensively studied and well documented, musculoskeletal (MS) manifestations of diabetes have received comparatively little attention. Musculoskeletal disorders in diabetes encompass a broad range of conditions such as adhesive capsulitis, limited joint mobility, diabetic cheiroarthropathy, Dupuytren’s contracture, trigger finger, carpal tunnel syndrome, osteoarthritis, and diabetic muscle infarction.⁵ These conditions can lead to chronic pain, joint stiffness, functional limitation, and disability, thereby substantially affecting daily activities and overall well-being of diabetic patients.^6,7 Despite their clinical relevance, MS disorders are often underdiagnosed and undertreated, as they may be overshadowed by more commonly recognized vascular complications⁸. Importantly, there is a striking paucity of data from the Indian subcontinent, where the burden of diabetes is rapidly increasing and poses a major public health challenge. India is home to one of the largest populations of individuals with diabetes globally, with unique demographic, genetic, lifestyle, and socioeconomic factors that may influence the pattern and prevalence of diabetic complications.^9-13 Differences in occupational activities, physical workload, nutritional status, healthcare access, and health-seeking behaviour may further modify the clinical spectrum of musculoskeletal disorders in Indian diabetic patients. The lack of region-specific data limits awareness among clinicians and hampers the development of targeted screening and management strategies for these conditions.

AIM

To examine the musculoskeletal manifestations in patients with diabetes mellitus and their correlation with disease duration, microvascular and macrovascular complications, and other associated factors at a tertiary care center in Northwest Rajasthan.