Background Diabetes mellitus (DM) affects the musculoskeletal (MSK) system, resulting in significant morbidity. These manifestations are unrecognized, though they are found in daily practice.Aim To study the effect of DM on the MSK system and the prevalence of these MSK disorders among Egyptians.Patients and methods In total, 100 patients with type 1 DM, 100 patients with type 2 DM, and 100 normal controls were examined for different types of MSK disorders. Fasting and postprandial blood glucose, glycosylated hemoglobin, and lipid profile testings were done for patients and controls. Plain radiography of the dorsolumbar region and ankle joint and nerve conduction study of the median nerve were done in some selected cases.Results These MSK manifestations were found in patients with types 1 and 2 DM, and their prevalence rates are as follows: carpal tunnel syndrome (14 and 5%, respectively), sclerodactyly (9 and 3%, respectively), Charcot joint (2 and 4%, respectively), limited joint mobility (2 and 6%, respectively), stenosing tenosynovitis (1 and 5%, respectively), shoulder capsulitis (1 and 10%, respectively), diffuse idiopathic skeletal hyperostosis (0 and 3%, respectively) and Dupuytren’s contracture (0 and 1%, respectively). MSK manifestations were more prevalent in patients with longer disease duration, poor glycemic control, and higher levels of lipid profile.Conclusion The result of this study emphasizes the importance of glycemic control and its relation to MSK manifestations, in addition to the new finding that elevated levels of low-density lipoprotein are significantly related to MSK manifestations.