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Every November, National Diabetes Month reminds us how far-reaching the effects of diabetes can be, not just on blood sugar and organs but on the spine as well.
At Advanced Neurosurgery, our fellowship-trained, board-certified team of spine specialists in Reno and Carson City, Nevada, sees the connection between diabetes and degenerative disc disease (DDD) more often than most people realize.
If you have diabetes or prediabetes, understanding how it affects your spinal health can help you take proactive steps to protect your mobility and comfort for the long term.
The diabetes–disc degeneration connection
To delve into the DDD-diabetes link, we first need to discuss how it affects the spine.
The soft, cushion-like discs between the spinal bones (vertebrae) tend to flatten and erode over time.
These discs are shock absorbers for your spine, so they play a central role in helping you move smoothly and pain-free.
Some amount of disc degeneration is normal: It happens to nearly everyone as they age. However, not everyone experiences DDD.
Technically, it's not a disease, despite the name. DDD actually refers to a collection of symptoms that can include back pain, which may radiate to the buttocks or legs. Some people also experience numbness and tingling in their extremities, and, in severe cases, leg muscle weakness and gait (walking) problems.
An ever-increasing body of evidence shows that people with diabetes are more likely to experience DDD and have more severe symptoms than their nondiabetic counterparts.
According to a study in Frontiers in Endocrinology, diabetes contributes to biochemical and structural changes that increase the likelihood of disc degeneration, even in people without typical wear-and-tear risk factors.
People with uncontrolled diabetes often experience more severe and advanced disc degeneration.
How diabetes increases the risk of disc degeneration
Diabetes raises the risk of disc degeneration in multiple ways.
Biochemical and mechanical changes
Chronic high blood sugar alters the structure of the extracellular matrix, the supportive network that maintains healthy tissue. It also changes the way this matrix functions, affecting how disc fibers form and respond to stress.
Over time, the discs lose elasticity and strength, increasing the risk of small tears, dehydration, and collapse.
Simply put, the discs weaken and are less able to support the spine’s natural movement. Everyday activities like bending or lifting may then cause pain or injury that wouldn't occur otherwise.
Cellular aging and cell death
Diabetes also speeds up cellular aging within the discs. High glucose levels promote apoptosis, or programmed cell death, in disc cells. This means fewer healthy cells are available to maintain and repair spinal tissue.
At the same time, the remaining cells function less efficiently, producing fewer proteins that help maintain healthy disc structure. Discs grow steadily less resilient, which is one of the key hallmarks of DDD.
Cartilage endplate damage
The cartilage endplates (the thin layers between the spinal discs and vertebral bones) normally deliver nutrients to the discs. In diabetes, these endplates often sustain microscopic damage and poor blood flow.
When the endplates don't deliver enough oxygen and nutrients, the discs essentially starve. This means they can't repair themselves, and that disc degeneration can accelerate.
Advanced glycation end products (AGEs)
High blood sugar also leads to the creation of advanced glycation end products (AGEs). These harmful compounds form when sugar molecules attach to proteins or fats.
These AGEs accumulate in the discs, causing stiffness and inflammation. Over time, AGEs interfere with the spine’s ability to absorb shock and can even contribute to nerve irritation.
Protecting your spine when you have diabetes
While these changes sound serious, there’s good news. Managing diabetes can help protect your spinal health.
Keeping your blood sugar within target range may not stop normal disc wear-and-tear, but it can significantly reduce your risk of developing DDD.
If you already have DDD and you're struggling with frustrating pain, our experienced pain management specialists can help. We offer the most advanced solutions, including regenerative medicine, which has shown tremendous promise for DDD. In addition, our surgeons use the most specialized surgical techniques, including artificial disc replacement, to ease pain and restore mobility.
At Advanced Neurosurgery, we understand how your overall health and spine health are interconnected. If you're living with diabetes and experiencing back or neck pain, early evaluation can make all the difference.
Our team can assess your spine’s condition and develop a personalized treatment plan that supports both your comfort and long-term function. Call or text us at 775.323.6100, or request an appointment by clicking here.