Need help navigating life with diabetes? You can always Ask D'Mine… Wanted back to our weekly Q&A column, hosted by veteran type 1 and diabetes author Wil Dubois.

Today, Wil's responding to a question astir pain in the knees and how that may (or may non) atomic number 4 consanguine to diabetes. Read happening for Sir Thomas More, and not just a "knee joint-jerking" response, but an always-insightful column from Wil.

{Got your own questions? Email us at AskDMine@diabetesmine.com }

Joe, type 1 from Vermont, writes: I have pain in my knees on and off, sometimes intense. Is this associated with diabetes? And can you urge a goodish vitamin to hold a genu pain? I am talking atomic number 20 but it doesn't seem to work. Thanks.

Wil@Ask D'Mine answers: I'm sorry to report card that the knee pain you're agony from could well equal associated with your diabetes. What a painfulness in the backside. And while I'm sure that regular readers—and diabetes vets in general—South Korean won't beryllium surprised to determine that there's yet ace to a greater extent elbow room diabetes can mess with our bodies, I confess to having a morbid fascination with all the uncounted ways one hiccup in the genome can lead to much widespread chaos.

The most common diabetes-triggered joint chaos is named neuropathic arthropathy, and if you'll pardon the pun, it's one of those the struggle-cram-is-connected-to-the-stifle-bone rather syndromes. Here's how IT works: uncontrolled diabetes causes high blood cabbage > high blood sugar causes neuropathy > neuropathy causes loss of sensation > loss of virtuoso stool result in unmarked joint injury > UN-noticed joint injury leads to people using a damaged integrated unawares > using a flyblown articulate unawares leads to further damage. In the case of neuropathic arthropathy, PWDs (masses with diabetes) wretched this sickness can whole wear down the cushioning cartilage in a joint resulting in physical friction bone damage. Ick. Oh, and with great care my fellow PWDs Don River't flavour too put upon, neuropathic arthropathy is non exclusive to diabetes. You tooshie also get it from syphilis, Hansen's disease, and chronic alcoholism — among different conditions and diseases.

Neuropathic arthropathy most unremarkably affects the feet and ankles—in fact, its common name is Charcot's foot—but it is seen in the knee as well, particularly in type 1s, and sometimes in patients who are quite young.

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Due to the fact that neuropathy is part of the recipe present, the first affair to do when considering if your knee pain in the neck could equal the result of Jean Martin Charcot's (called later on the pioneering Daniel Chester French neurologist Blue jean-Martin Charcot) is to be honest with yourself about the quality of your diabetes control. And I preceptor't reasonable imply the calibre of your live control, but the tone of your control, boilers suit, since diagnosis. Complications, so much as neuropathy, arse come through home to roost years, or even decades, after the damage was first inflicted. Of course, that's not to enounce you shouldn't strive for the best ensure imaginable for your diabetes, but if you had a long-dated spell of impoverished ascendence in your young, you'ray at higher risk of neuropathy, and thence Charcot's.

IT's also interesting to bank bill that neuropathy apart, apparently glucose has a pessimistic wallop on collagen, the stuff the cushioning cartridge is ready-made of. Just the way blood cells glycate when exposed to glucose, so too does collagen tissue, which butt cause the cartilage to stiffen. Meanwhile, enquiry by Dr. Tord Kjellström (who gets this calendar month's award for the coolest name), showed that collagen from type 1s responds very other than than collagen from character 2s when exposed to glucose.

If you suspect Charcot's, somewhat paradoxically, your number 1 stop to get your knee treated is at chiropodist's office, rather than an orthoptist's. As Charcot's most often affects the feet, podiatrists are the most acquainted with the condition.

Moving on to the next way the big-D takes a toll on our joints, the number two slot is taken by osteoarthritis. In this case, the diabetes isn't at fault so much as the exuberant body mass we historically get wind in type 2s, and increasingly see in type 1s. To be blunt, if you are a rich type 1, you could be suffering from osteoarthritis, which can embody either triggered or exacerbated by weight. If this is the case, skip the ft doc and visit a rheumatologist. And a dietitian.

Somewhat related, is a grimmer contour of arthritis called Atrophic arthritis, which is an autoimmune disease commonly linked to typecast 1 diabetes. Apparently, diagnosing RA is no simple matter as there's not a single test for it; rather a number of lab tests and imaging studies are requisite to ferret it down. The labs can include an ESR, a C-reactive protein, and something called anti-cyclic citrullinated peptide antibodies. Imaging runs the gauntlet from X-ray to MRI with ultrasound in-between. I hope you have solid health insurance.

Lag, on to your question about vitamins for knee pain. Patc not actually a vitamin, many patients suffering articulatio genus pain for a wide range of conditions find that taking the gristle factor glucosamine helps. It's generally well-advised safe, although science on its effectiveness—as with about supplements—is controversial. That aforementioned, years ago my wife and I had an over-the-hill dog that had a lot of knee problems, and our hippie vet place Canine Kody on glucosamine, and damn if it didn't help. I'm not saying you're an old Canis familiaris, but what deeds for one mammal mightiness work for another. Simply that's not to say you should avoid getting some professional medical advice connected you knee. And nary, my hippie vet doesn't numeration when it comes to professional medical advice.

Else over the counter compounds that people report achiever with are:

  • Chondroitin, a chemical found in cooperative gristle, which is thought to inhibit the activeness of substances that die collagen in joints.
  • Ginger, which as symptomless as beingness a spice has a long-standing place in folk medicine, and is believed by some to have some opposed-inflammatory and antioxidant properties.
  • Omega-3 Pisces oil color, which blocks instigative reactions, can apparently reduce or carry off the need for NSAIDs (NSAID drugs) in some RA patients, according to the Arthritis Foundation. Positive, IT's good for your heart!
  • MSM, which is slang for methylsulfonylmethane, a sulphur-containing parted that helps some people suffering from joint degeneration, mostly likely serving in an anti-inflammatory fashion.

And finally, the solitary actualised vitamin I could find for you that some people take for knee pain is D, which functions in a carousel way. As it turns knocked out, cardinal of the symptoms of vitamin D deficiency is joint pain. So you might want to have your vitamin D levels restrained. It would glucinium humorous if your human knee pain was from this little-d rather than from the big-D we all worry about.

This is not a medical advice column. We are PWDs freely and openly unselfish the sapience of our collected experiences — our been-there-done-that cognition from the trenches. Bottom line: you still pauperization the guidance and care of a accredited Graeco-Roman deity professional.