Molecular Links Between Diabetes and Osteoarthritis: The Role of Physical Activity

Background: Diabetes mellitus (DM) and osteoarthritis (OA) are two of the most relevant and common chronic diseases affecting older people. Both DM and OA are considered metabolic diseases due to their high correlation with the capacity of the body to metabolize some nutritive substances such as glucose, fat, vitamins and also the response to oxidative molecules. Methods: We searched PubMed, Scopus, Google Scholar, and authors' bibliographies in order to extract articles regarding the relationship between DM and OA. Objective: The main purpose of this review is to investigate the molecules involved in the onset and progression of both DM and OA and the beneficial role of physical activity. Results: The main focus is on the importance of glucose metabolism and its derivatives in the pathogenesis of OA and DM. Advanced glycation end-product (AGEs), sorbitol and diacylglycerol (DAG) are glucose derivatives which promote the activation of several pathways, most of them involved in the activation of inflammatory processes. The possible link between DM and OA is represented by the inflammatory process deriving from the increased expression of pro-inflammatory cytokines. Moreover, we investigated the biological mechanisms and the clinical findings that confirm a beneficial effect of physical activity in both DM and OA. Conclusion: Thus a tailored and adapted physical activity can be used in the treatment of both diseases as a part of a correct and healthy lifestyle. For this reason we strongly suggest the scientific community to introduce mild physical activity as part of our lifestyle to prevent metabolism diseases and osteoarthritis. Keywords: Diabetes mellitus, osteoarthritis, physical activity, AGEs, sorbitol, diacylglycerol.