Ankle Arthritis Is Linked to Diabetes Risk, Study Finds

From en.sedaily.com 

Research team led by Professor Kim Woo-sup at Konkuk University Medical Center Study of 262 ankle arthritis patients with an average age of 67 Analysis of the link between arthritis severity and physical activity levels

Leaving common ankle arthritis untreated can reduce physical activity and lead to metabolic diseases such as diabetes and cardiovascular disease, according to a new study.

Konkuk University Medical Center said on the 10th that a research team led by orthopaedic surgery Professor Kim Woo-sup analysed 262 ankle arthritis patients who visited its foot and ankle specialty clinic between June 2022 and October 2024, presenting evidence that ankle arthritis should be viewed not as an orthopaedic problem but as an issue of whole-body health.

Ankle arthritis is a condition affecting approximately 1% of the global population. About 50,000 new patients are reported each year. Although it is relatively less recognized than knee or hip arthritis, pain and gait impairment are severe due to the nature of the ankle joint, where body-weight loading is concentrated. In particular, ankle arthritis is more often caused by trauma-related fractures and ligament injuries than by degeneration. If left untreated or not treated properly in time, the joint cartilage can become damaged years later and progress into arthritis.

This study was conducted on 163 women and 99 men with an average age of 66.8. Using weight-bearing ankle X-rays, the research team divided the participants' arthritis severity into four stages based on the Takakura stage classification system. Physical activity levels were measured through the International Physical Activity Questionnaire (IPAQ-SF), divided into walking, moderate activity, and vigorous activity.

According to the analysis, the higher the arthritis severity in X-ray imaging, the more both vigorous physical activity and total activity decreased in a statistically significant manner. Notably, not a single response indicating vigorous physical activity was recorded among stage 4 patients, who correspond to end-stage ankle arthritis. Patients' age and body mass index (BMI) also showed a correlation with reduced activity. Beyond simply confirming the common notion that "people move less when their joints hurt," the study statistically confirmed the correlation between the objective severity of ankle arthritis and activity levels while controlling for major variables such as age, sex, BMI, and pain intensity. It also holds clinical significance in that it presented a hypothesis on the impact that reduced activity may have on whole-body metabolic health.

Regular physical activity not only increases insulin sensitivity but also helps control blood sugar and improve blood lipids. It is also effective in reducing chronic inflammation in the body. Conversely, when activity decreases, these protective effects disappear, potentially raising the risk of developing diabetes, hyperlipidemia, and cardiovascular disease. However, the fact that the study did not directly measure the occurrence of metabolic diseases is cited as a limitation. Additional long-term follow-up studies are needed to establish a causal relationship.

Currently, the treatment of ankle arthritis is focused on reducing pain. In the early stages, the goal is to reduce pain and maintain joint function through conservative treatments such as medication, injection therapy, and wearing braces. When deformity or joint damage has progressed, surgical treatments such as osteotomy, arthrodesis, and total ankle replacement are considered by comprehensively taking into account lower-limb alignment, the degree of joint deformity, and the patient's activity level and age. This study contains a clinical recommendation that treatment goals should extend beyond pain reduction to the recovery of activity.

"This is a study showing that ankle arthritis is not simply a matter of ankle pain but can be linked to reduced physical activity," Professor Kim Woo-sup stressed. "For ankle arthritis patients, a treatment strategy that not only controls pain but also maintains and restores activity is important." He added, "When ankle arthritis progresses, patients cannot move due to pain, and as activity decreases, their whole-body health can also be negatively affected," and "receiving accurate diagnosis and treatment early on helps reduce pain and maintain activity."

The study was published in a recent issue of the international journal PLOS One.

https://en.sedaily.com/culture/2026/07/12/ankle-arthritis-linked-to-diabetes-risk-study-finds