Abstract—: Osteoarthritis (OA) and type 2 diabetes mellitus (T2DM) are the two most common chronic diseases that have many common epidemiological characteristics, share common risk factors, and are heterogeneous, multifactorial pathologies, which occur on interaction of genetic factors and environmental factors. In addition, these diseases are often occurring in the same patient. Despite the differences in clinical manifestation, both diseases are characterized by similar impairments of cellular metabolism, primarily associated with the energy production and utilization in the form of ATP. The review discusses the molecular mechanisms underlying pathophysiological processes associated with metabolism of glucose and lipids, as well as the ways to overcome impairments of energy metabolism as a new therapeutic approach.