Background Diabetes mellitus (DM) significantly impacts joint function, particularly affecting the shoulder, which plays a crucial role in mobility and daily activities. Frozen shoulder (FS) is notably more prevalent in individuals with diabetes, affecting approximately 10%–38% of diabetic patients, compared to 2%–5% in the general population. This highlights a strong correlation between diabetes and FS.
Objective: This review seeks to offer a contemporary viewpoint on the correlation between diabetes and frozen shoulder.
Methods: A systematic search was conducted using Google Scholar, Science Direct, PubMed, and Consensus databases with keywords including "diabetes mellitus," "frozen shoulder," and "adhesive capsulitis." The review includes studies published between January 2010 and January 2025, focusing on both Type 1 and Type 2 diabetes. Non-peer-reviewed studies, conference abstracts, and case reports were excluded.
Results: Several factors have been found to have a role in the development of tendon alterations and increased capsular stiffness, which can result in restricted shoulder mobility. These factors include age, duration of diabetes, glycated hemoglobin (HbA1c), advanced glycation end products (AGEs), vascular endothelial growth factor (VEGF), and interleukin-1ß (IL-1ß). Frozen shoulder is far more common in diabetes people, according to the research.
Conclusion: There is substantial evidence in the current literature linking diabetes to frozen shoulder. The exact mechanisms remain unclear, necessitating further research to explore the multifactorial nature of this condition. While manual therapy and exercise-based physiotherapy remain standard treatment approaches, limited research exists on tailored physiotherapy protocols based on tissue irritability levels.