TY - JOUR
T1 - Increased Risk of Tendon Injury Following Structured Care in Patients With Type 2 Diabetes
T2 - Post Hoc Analysis of a Large Randomized Controlled Trial With 19 Years of Follow-up
AU - Stausholm, Martin B.
AU - Siersma, Volkert
AU - Køster-Rasmussen, Rasmus
AU - Waagepetersen, Asger
AU - Pedersen, Zandra O.
AU - Magnusson, S. P.
AU - Kjær, Michael
AU - Couppe, Christian
N1 - Funding Information:
This study was supported by RegionH, Bispebjerg Hospital, Center for Healthy Aging (Nordea Foundation), University of Copenhagen, and the Danish Medical Research Council.
PY - 2024
Y1 - 2024
N2 - Tendon rupture and tendinopathy can arise from sudden occurrences and repetitive overuse and can result in a permanently reduced physical activity level (1,2). Tendon injuries are prevalent in both physically active and sedentary individuals, but the risk increases with age and with type 2 diabetes (1,3). The latter is likely due to the long-standing glycation and metabolic impact of diabetes on tendon tissue, impairing tendon structure and function, thereby increasing brittleness (2,3). We recently demonstrated that individuals with elevated glycated hemoglobin, even in the prediabetes range (HbA1c >5.7%, >39.8 mmol/L), had three-times-higher odds of developing tendon injury in the lower extremities compared with individuals with normal levels (4). Additionally, hypercholesterolemia (total cholesterol >5 mmol/L) was associated with 1.5-times-higher odds of tendon injury in the upper extremities, and individuals with metabolic syndrome had 2.5-times-higher odds of tendon injury in both upper and lower extremities (4). Hence, it is reasonable to assume that modern type 2 diabetes care, which serves to lower HbA1c and regulate dyslipidemia, would lower the risk of tendon injuries, although it remains to be established.
AB - Tendon rupture and tendinopathy can arise from sudden occurrences and repetitive overuse and can result in a permanently reduced physical activity level (1,2). Tendon injuries are prevalent in both physically active and sedentary individuals, but the risk increases with age and with type 2 diabetes (1,3). The latter is likely due to the long-standing glycation and metabolic impact of diabetes on tendon tissue, impairing tendon structure and function, thereby increasing brittleness (2,3). We recently demonstrated that individuals with elevated glycated hemoglobin, even in the prediabetes range (HbA1c >5.7%, >39.8 mmol/L), had three-times-higher odds of developing tendon injury in the lower extremities compared with individuals with normal levels (4). Additionally, hypercholesterolemia (total cholesterol >5 mmol/L) was associated with 1.5-times-higher odds of tendon injury in the upper extremities, and individuals with metabolic syndrome had 2.5-times-higher odds of tendon injury in both upper and lower extremities (4). Hence, it is reasonable to assume that modern type 2 diabetes care, which serves to lower HbA1c and regulate dyslipidemia, would lower the risk of tendon injuries, although it remains to be established.
U2 - 10.2337/dc24-0330
DO - 10.2337/dc24-0330
M3 - Comment/debate
C2 - 38781039
AN - SCOPUS:85200675588
VL - 47
SP - e57-e58
JO - Diabetes Care
JF - Diabetes Care
SN - 1935-5548
IS - 8
ER -