Surreal illustration of a knee joint with sugar crystals and insulin molecules representing the connection between diabetes and osteoarthritis.

Knee Osteoarthritis: Is Diabetes the Culprit?

Soraya Malik in Health & Wellness November 2025 • 4 min read.

"New research dives deep into the connection between diabetes, blood sugar, and joint health."

Knee osteoarthritis (OA) is a widespread problem, causing pain, stiffness, and reduced mobility for millions. While wear and tear were long considered the primary cause, scientists now recognize that metabolic factors, like those related to diabetes, may also play a significant role. This begs the question: If you have diabetes or struggle with blood sugar, are you automatically destined for knee problems?

For years, studies have explored the possible link between diabetes mellitus (DM) and osteoarthritis (OA), but the evidence has been mixed. Some research suggests a connection, while others have found no direct relationship. Adding to the confusion, many studies haven't fully accounted for other influential factors like obesity, which is a known risk for both diabetes and OA. This means understanding the true impact of diabetes on knee health has been a puzzle.

A recent analysis from the Multicenter Osteoarthritis Study (MOST) attempts to clarify the relationship. By examining a large group of adults with careful attention to blood sugar markers and body mass index (BMI), the study sheds light on whether diabetes and related metabolic issues directly influence the development of knee osteoarthritis. The findings may change how you think about managing your joint health.

Decoding the Diabetes-Knee Osteoarthritis Connection

Surreal illustration of a knee joint with sugar crystals and insulin molecules representing the connection between diabetes and osteoarthritis.

Researchers delved into data from the MOST study, which included over 3,000 men and women aged 50-79, all at risk for knee OA. Of this group, a subset of 987 participants underwent detailed blood sugar and insulin resistance testing. The team tracked the development of radiographic knee osteoarthritis (RKOA) – visible signs of OA on X-rays – over a period of seven years.

The scientists considered several factors when evaluating the relationship between diabetes and knee OA. These included:

Whether participants had been diagnosed with diabetes.
Their fasting blood glucose levels.
Their insulin resistance, measured using the HOMA-IR index.
Body mass index (BMI) at each visit.

After crunching the numbers and accounting for key variables like age, sex, race, and especially BMI, the study revealed a fascinating nuance: While diabetes itself wasn't directly associated with a higher risk of knee OA, insulin resistance seemed to play a different role, particularly in women.

The Big Picture: What This Means for Your Knees

This research underscores the complex relationship between metabolic health and joint health. While simply having diabetes may not automatically doom your knees, maintaining healthy blood sugar levels and managing insulin resistance, particularly for women, could be important pieces of the puzzle. Further research is needed, but the findings suggest that proactive steps towards metabolic wellness might offer a protective effect for your joints.

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Everything You Need To Know

What is knee osteoarthritis, and how might diabetes be connected?

Knee osteoarthritis (OA) is a condition characterized by pain, stiffness, and reduced mobility in the knee joint. It has traditionally been attributed to wear and tear, but current research suggests that metabolic factors, similar to those found in diabetes mellitus (DM), can contribute significantly to its development. The recent analysis from the Multicenter Osteoarthritis Study (MOST) clarifies the relationship between diabetes, insulin resistance, and knee health.

Does having diabetes automatically mean I'll develop knee osteoarthritis?

The MOST study, which tracked over 3,000 adults, revealed that diabetes mellitus (DM) itself wasn't directly linked to a higher risk of radiographic knee osteoarthritis (RKOA). However, insulin resistance, measured by the HOMA-IR index, appeared to play a role, especially in women. Maintaining healthy blood sugar levels and managing insulin resistance could be crucial for joint health.

What is insulin resistance, and how does it relate to knee osteoarthritis?

Insulin resistance, assessed using the HOMA-IR index, shows a potential link to radiographic knee osteoarthritis (RKOA), particularly in women. This means that when cells don't respond effectively to insulin, it could affect joint health. However, further research is needed to fully understand the mechanisms and to confirm these findings.

What key factors were examined in the MOST study to understand the connection between diabetes and knee health?

The MOST study considered factors such as diagnosed diabetes mellitus (DM), fasting blood glucose levels, insulin resistance (using the HOMA-IR index), and body mass index (BMI). By accounting for these variables, researchers aimed to isolate the specific impact of diabetes and related metabolic issues on the development of radiographic knee osteoarthritis (RKOA).

If managing blood sugar and insulin resistance is important, what specific steps should I take to protect my knees, and what further research is needed?

While this research from the Multicenter Osteoarthritis Study (MOST) suggests that managing insulin resistance and maintaining healthy blood sugar may offer a protective effect, it doesn't provide specific recommendations for everyone. Individuals should consult with healthcare professionals for personalized advice. Further research is needed to confirm and expand upon these findings, exploring new avenues for preventing and managing knee osteoarthritis (OA) through metabolic wellness.