Why are individuals with diabetes especially prone to developing frozen shoulder? — Kelly Eells, APNP, Sheboygan, Wis.

Frozen shoulder, or adhesive capsulitis, has a prevalence in the general population of about 2%. In patients with diabetes, the prevalence is estimated at anywhere from 10% to 29%. The increase is felt to be largely due to the changes that occur in the presence of elevated blood glucose levels.

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Glucose and collagen interact in what is known as “cross-linking,” which produces a glycosylated end product that is rigid and irreversible. This same process is also thought to be involved in the development of microantiopathy associated with diabetes. — Sherril Sego, FNP-C, DNP (181-1)