I am 34 years old and have had type 1 for nearly fifteen years. My blood sugar control was initially appalling, but last six years has been good. As yet I have no discernable complications. Over the last two months, I have experienced pain in my shoulder joints, which seems to radiate down my arm. The pain is worse at night, and feels almost to be in the bones. My endocrinologist said it may be soft tissue damage from glucose deposits. Could you explain, advise re minimizing/treating pain? I fear that I will be stuck with this pain for the rest of my life.

Limited Joint Mobility (LJM) syndrome is a well known chronic complication of type 1 diabetes that leads to multiple joint contractures with frequent arthralgia. It is estimated to afflict 20-30% of patients. Increased non-enzymatic long term glycosylation of proteins (AGE) such as the collagen (cross linkages leading to less solubility of the collagen molecules) of joint tissues has been postulated to contribute to this syndrome. Increased thickness of collagen can be reversible with improved metabolic control and I’d rather suggest to check your HbA1c levels over time. Non-steroidal antiinflammatory medications may be of help to reduce pain of the shoulder. A orthopedic consultation is also recommended.

MS

[Editor’s comment: Pain radiating down the arm may also be a sign of heart disease. Be sure your endocrinologist has checked you out for this as well.

SS]