Ally,
I have some thoughts for you. It sounds like you're describing this systemic, degeneration. It's not like you tore one or two muscles several years apart, and as you state, they weren't due to trauma. I suggest that the cause of all these events is your diabetes, for several reasons. Diabetics tend to have low levels of inflammation, all the time. Most studies focus on the inflammation affecting the heart, and this is why diabetics have a higher incidence of heart disease. However, this inflammation is all over your body, and in your case it may have manifested as a degeneration of your joints. Even if you take your insulin every day, I believe there is still a small level of inflammation. Now if your insulin dose is insufficient, you would have a higher level of inflammation. Sometimes drugs can decrease the potency of insulin. Two of the drugs you mentioned - although not contraindicated - have "monitor warnings" when taking with insulin. Birth control, or estrogens themselves, can raise you blood sugar, requiring more insulin. Also, the promethazine - which by the way is contraindicated with lexapro and methadone - also causes an increase in blood sugar. The other possibility is that you are experiencing a lack of blood flow to the joints, caused by the hyperglycemia.
Obviously, before you ever mess around with your insulin, talk to your doctor. As you have experience with this disease you most likely know this.
You're probably going to say that the last time you checked your blood glucose, it was fine, however I'm not sure if these effects can be ruled out just because one has a normal glucose level.
Hope that helps, and good luck.
