Type 2 Diabetes May Alter Spinal Collagen and Cause Back Pain

Kevin Brooks

Written by Kevin Brooks


Type 2 diabetes, a condition affecting approximately 508 million people worldwide, is known for its challenges in insulin use and a host of related health risks. Among these, heart disease, stroke, high blood pressure, kidney disease, and dementia are well-documented. However, researchers are now shedding light on another distressing complication: back pain.

Recent findings from scientists at the University of California San Diego and the University of Utah point to a significant impact of type 2 diabetes on vertebral discs. These discoveries suggest a direct connection between diabetes-related damage to these discs and chronic body pain, including persistent back pain.

Unveiling the Link Between Diabetes and Vertebral Disc Damage

For individuals with type 2 diabetes, the list of potential health issues extends to nerve damage, eye diseases, skin conditions, sleep disturbances, and an array of chronic pain manifestations. A new study published in PNAS Nexus delves into how diabetes could be the culprit behind deteriorating spinal health. Past research has already indicated a heightened risk of various spinal conditions in diabetic patients, such as diffuse idiopathic skeletal hyperostosis (DISH), lumbar disc degeneration, spinal stenosis, and vertebral osteomyelitis. Furthermore, statistics reveal that diabetics face a 35% increased risk of experiencing low back pain and a 24% greater chance of neck pain.

Focusing on vertebral discs, which have shown noticeable effects from diabetes, researchers employed an animal model to compare the spinal health of rats with type 2 diabetes against that of healthy counterparts. Findings from this study indicate that the collagen fibrils within the vertebral discs of diabetic rats became rigid and brittle. This change undermined the discs’ ability to compress effectively, leading to back pain and potential spinal issues.

Understanding the Science Behind Diabetes-Induced Spinal Issues

The study attributes the stiffness and brittleness of the collagen to hyperglycemia-induced acceleration of collagen cross-linking, a process that simulates the rapid aging of the discs. This cross-linking hinders the discs’ innate compression mechanisms, much like how the aging process affects the spine’s flexibility and resistance to pressure.

To uncover these changes, researchers utilized a technique known as synchrotron small-angle x-ray scattering (SAXS). This method measures the periodicity and deformation of collagen fibrils under tension, providing a detailed visualization of how strain transfers to collagen at the nanoscale. It’s a crucial step in understanding the complex interplay between diabetes and spinal health.

Future Directions for Treatment and Research

This research has paved the way for potential treatments that may focus on removing cross-links to restore normal disc function. However, understanding and monitoring the presence of advanced glycation end-products (AGEs)—which are biomarkers for aging and degenerative conditions—remains a challenge. Assessing AGEs content in discs or bones is complicated, and scientists are exploring the possibility of using skin assessments as a proxy.

Dr. Neel Anand of Cedars-Sinai Spine Center emphasizes the importance of the study’s findings, noting the broader implications of type 2 diabetes as a collagen disease affecting the entire body. While the study offers compelling evidence from an animal model, Dr. Anand also highlights the need for human-based studies to confirm these impacts fully.

Takeaway for Those Living with Type 2 Diabetes

As research progresses, it becomes increasingly clear that type 2 diabetes is more than just a metabolic disorder—it can also be considered a collagen disease with widespread effects on the body, including the spine. With millions affected by both diabetes and back pain, understanding the connection between these two conditions is vital for developing targeted treatments and improving the quality of life for many. The ongoing research not only opens new doors for medical interventions but also underscores the importance of comprehensive diabetes management to prevent such debilitating complications.