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.

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)