Here’s an eye-opening study in regards to diabetes and tendinopathy. Individuals with diabetes had more than 3x the odds of tendinopahy compared to controls. Although there were no direct casual relationships, here are some proposed reasons:
Hyperglycemia associated with diabetes affects collagen linkages in tendons and reduces proteoglycans (proteins found in connective tissues)
Statins, which help control cholesterol, have a higher usage in diabetic individuals. Statins have been shown to induce tendinopathy in people.
Excess adipose tissue. The average BMI in diabetic individuals is over 30 which correlates higher levels of adiposity in diabetic individuals. Studies have shown associations between tendinopathy and adiposity.