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Wagner S, Nørgaard K, Willaing I, Olesen K, Andersen HU. The impact of upper extremity impairments on work and everyday life of people with type 1 diabetes-A nationwide controlled study. Diabet Med 2024; 41:e15158. [PMID: 37257066 DOI: 10.1111/dme.15158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/15/2023] [Accepted: 05/30/2023] [Indexed: 06/02/2023]
Abstract
AIMS The study objective was to explore how upper extremity impairments (UEIs) affect the everyday life and work-life of people with type 1 diabetes (T1D) and to compare them to a control group without T1D to determine if there are diabetes-specific consequences of UEIs. METHODS In a controlled cross-sectional study, a survey was distributed across all regions of Denmark. A total of 2174 people with T1D and 827 controls were included in the study population. The survey addressed UEI symptoms, employment status, functional disability, mental well-being and diabetes distress. Data were analysed using multivariable logistic and linear regression. RESULTS Upper extremity impairments were associated with a higher rate of work absence and modification, but no more so for people with T1D than for the control group. Among people with T1D, UEIs were significantly associated with worse mental well-being and diabetes distress, and across all outcomes including functional disability, additive effects were found with an increasing number of coexisting impairments. The impact of UEIs on functional disability was more severe for the T1D group than the control group, but this was primarily due to differences in the number of coexisting impairments. CONCLUSIONS Upper extremity impairments have significant negative implications for the work-life and everyday life of people with T1D, and interventions to reduce UEIs and their impact among this group are highly relevant.
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Affiliation(s)
- Sabina Wagner
- Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Kirsten Nørgaard
- Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ingrid Willaing
- Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Olesen
- Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Henrik U Andersen
- Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark
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Pinhal KC, Figueiredo PS, De Oliveira VC, Gomes WF, Pernambuco AP, Alcantara MA. Functional decline in people with diabetes: Bidirectional relationships between body function and activity-participation components in a two-wave longitudinal structural equation modeling. Physiother Theory Pract 2023; 39:598-606. [PMID: 35057703 DOI: 10.1080/09593985.2021.2023923] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined the impact of diabetes over time. The sample included 68 people with diabetes used a three-year longitudinal design to test a model of functional decline. Indicators of the body function and activity and participation components of the International Classification of Functioning, Disability and Health (ICF) were derived from the Nordic Musculoskeletal Questionnaire, World Health Organization Quality of Life-Brief version (WHOQOL-BREF), and Participation Scale. On the basis of the ICF framework, it is hypothesized and found that there is an interaction between the body function and the activity and participation components, which, in turn, are predictors of future functional capability. The structural equation analyses confirmed that at both T1 and T2 pain measures are associated with physical, psychological, and social functioning; environmental factors mediate the relationship between these two constructs. Moreover, the activity and participation component at T1 predicted the body function component at T2. The main finding suggests that functional consequences of diabetes are complex and multifactorial. The significant functional decline in people with diabetes in just three years is worrying. The theoretical and practical implications of these findings are discussed.
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Affiliation(s)
- Kaio C Pinhal
- Programa de Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil
| | - Pedro S Figueiredo
- Programa de Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil.,Department of Physiotherapy, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil
| | - Vinícius C De Oliveira
- Programa de Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil.,Department of Physiotherapy, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil
| | - Wellington F Gomes
- Department of Physiotherapy, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil
| | - Andrei P Pernambuco
- Department of Physiotherapy, Centro Universitário de Formiga (Unifor-mg), Formiga, Minas Gerais, Brazil
| | - Marcus A Alcantara
- Programa de Pós-Graduação Em Reabilitação E Desempenho Funcional, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil.,Department of Physiotherapy, Universidade Federal Dos Vales Do Jequitinhonha E Mucuri (Ufvjm), Brazil
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Löfgren JP, Zimmerman M, Dahlin LB, Nilsson PM, Rydberg M. Diabetes Mellitus as a Risk Factor for Trigger Finger –a Longitudinal Cohort Study Over More Than 20 Years. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2021; 2:708721. [PMID: 36994346 PMCID: PMC10012113 DOI: 10.3389/fcdhc.2021.708721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022]
Abstract
Background and AimTrigger finger (TF) or stenosing tenosynovitis has been associated with diabetes mellitus (DM), although today’s knowledge is mostly based on cross-sectional and case-control studies. Thus, the aim of the present population-based cohort study over more than 20 years was to investigate DM as a risk factor for TF.MethodsData from Malmö Diet and Cancer Study (MDCS), including 30,446 individuals, were analysed with regards to baseline DM and known or potential confounders. Information regarding TF diagnosis until study end date of Dec 31st, 2018, was retrieved from the Swedish National Patient Register (NPR) using ICD-codes. Survival probability was investigated in Kaplan-Meier plots. Cox proportional hazard regression model was used to evaluate DM as risk factor for TF, adjusted for several confounders and presented as Hazard Ratio (HR) with 95% confidence intervals (CI).ResultsAt baseline, 4.6% (1,393/30,357) participants had DM. In total, 3.2% (974/30,357) participants were diagnosed with TF during the study period. Kaplan-Meier plot showed that the probability for incident TF was significantly higher in participants with baseline DM compared with individuals without baseline DM. Adjusted HR for DM as risk factor for TF was 2.0 (95% CI: 1.5-2.6, p<0.001).ConclusionThis longitudinal study showed that DM is an important risk factor for developing TF. When adjusting for sex, age, BMI, manual work, statin use, smoking and alcohol consumption, DM remained the main risk factor for TF.
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Affiliation(s)
- Jin Persson Löfgren
- Department of Translational Medicine, Hand Surgery, Lund University, Malmö, Sweden
- *Correspondence: Jin Persson Löfgren,
| | - Malin Zimmerman
- Department of Translational Medicine, Hand Surgery, Lund University, Malmö, Sweden
- Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
| | - Lars B. Dahlin
- Department of Translational Medicine, Hand Surgery, Lund University, Malmö, Sweden
- Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
| | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Mattias Rydberg
- Department of Translational Medicine, Hand Surgery, Lund University, Malmö, Sweden
- Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
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Farooq MN, Mehmood A, Amjad F, Syed J. Shoulder pain and functional disability in type 1 diabetic patients: A cross-sectional survey. Pak J Med Sci 2021; 37:1211-1214. [PMID: 34290810 PMCID: PMC8281183 DOI: 10.12669/pjms.37.4.3401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 02/23/2021] [Accepted: 03/03/2021] [Indexed: 11/15/2022] Open
Abstract
Objective To assess the prevalence of shoulder pain and functional disability (SPFD) in Type-1 diabetic patients, and to explore its association with duration of the disease, age and gender. Methods A cross-sectional survey was carried out on previously diagnosed patients with Type-1 diabetes mellitus between April 2019 and March 2020. Data was collected from six hospitals including three tertiary care hospitals of Islamabad and Rawalpindi. Three hundred and twenty-eight patients were recruited through convenience sampling. Shoulder Pain and Disability Index was used to determine SPFD among participants. Point-biserial and Pearson correlation coefficients were calculated to find out the correlation between the variables. Independent t-test was used to determine the difference in the mean scores between the variables. Results The prevalence of SPFD was found 85.7%. A significant correlation was found of the SPFD with age (r = 0.332, p < 0.001), duration of the diabetes mellitus (r = 0.154, p = 0.005) and gender (rpb = 0.171, p = 0.002). A significant difference was found in SPFD mean scores between female and male patients (female patients = 43.42±22.80, male patients = 35.31±22.91, p = 0.002). Conclusion SPFD seems prevalent among Type-1 diabetic patients. Increasing age, long history of diabetes mellitus and female gender appear the associated risk factors for the shoulder pain and disability.
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Affiliation(s)
- Muhammad Nazim Farooq
- Muhammad Nazim Farooq, PhD. Islamabad College of Physiotherapy, Margalla Institute of Health Sciences Rawalpindi, Rawalpindi, Pakistan
| | - Aqsa Mehmood
- Aqsa Mehmood, DPT Islamabad College of Physiotherapy, Margalla Institute of Health Sciences Rawalpindi, Rawalpindi, Pakistan
| | - Fatima Amjad
- Fatima Amjad, DPT Islamabad College of Physiotherapy, Margalla Institute of Health Sciences Rawalpindi, Rawalpindi, Pakistan
| | - Jaweria Syed
- Jaweria Syed, MS-SPT Shifa Tameer-e-Millat University, Islamabad, Pakistan
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Abstract
BACKGROUND Dupuytren's disease is a common complex disease caused by genetic and nongenetic factors. The role of many nongenetic risk factors is still unclear and debatable. This study aimed to systematically review the association between Dupuytren's disease and nongenetic risk factors. METHODS A search strategy was developed based on the Population, Exposure, Comparison, Outcomes and Study framework. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant literature search was conducted in MEDLINE, Embase, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from inception to November of 2018. Title and abstract and then full-text screening against eligibility criteria was performed independently by two reviewers, and consensus was achieved by a third reviewer. The Effective Public Health Practice Project and the Oxford Centre for Evidence Based Medicine tools were used to assess study quality and to evaluate the level of evidence of included studies, respectively. RESULTS Reviewers identified 4434 studies, of which 54 were included in the analysis. There was strong evidence for the association between Dupuytren's disease and advanced age, male sex, family history of Dupuytren's disease, and diabetes mellitus. Furthermore, heavy alcohol drinking, cigarette smoking, and manual work exposure showed a significant dose-response relationship. The quality of the included studies was mainly low or moderate, and most studies were level 3 or 4 on the Oxford Centre for Evidence Based Medicine scale. CONCLUSIONS The study results show a strong association between Dupuytren's disease and advanced age, male sex, family history of Dupuytren's disease, diabetes mellitus, heavy alcohol drinking, cigarette smoking, and manual work exposure. Further studies are required to explain the causal relationship of these associations.
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Nørgaard K, Kielgast U. Quality of Life is Markedly Impaired by Rheumatological and Skin Manifestations in Patients with Type 1 Diabetes: A Questionnaire Survey. Diabetes Ther 2019; 10:635-647. [PMID: 30778903 PMCID: PMC6437232 DOI: 10.1007/s13300-019-0587-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION To estimate lifetime prevalence of diabetes-related upper limb and non-acquired skin manifestations in a representative type 1 diabetes (T1D) population and to identify associations between these conditions and quality of life. METHODS A questionnaire on these complications and measures of quality of life (World Health Organization-Five Well-Being Index [WHO-5]), depression, and diabetes-specific burden (Problem Areas in Diabetes [PAID] scale) was sent to all T1D patients in a Danish clinic (N = 583). RESULTS The response rate was 68.6%. Lifetime prevalence of any upper limb soft tissue lesion was 72%; prevalence of any skin lesion was 10.5%. Frozen shoulder and vitiligo were most common upper limb and skin manifestation, at a prevalence of 53 and 9.1%, respectively. Compared to patients with no skin lesion, those with at least one skin lesion had more depression (19 vs. 33%; P < 0.01) and lower WHO-5 scores. Frozen shoulder was associated with lower WHO-5 scores (P < 0.001), more depression (29 vs. 14%; P < 0.001), and a higher PAID score (P < 0.01). A diagnosis of carpal tunnel syndrome was associated with lower WHO-5 scores (P < 0.001), a higher risk of depression (29 vs. 16%; P < 0.01), and a higher PAID score (P < 0.001). CONCLUSION Upper limb soft tissue lesions and diabetes-specific non-acquired skin lesions are very common in patients with T1D and strongly associated with impaired life quality and increased risk of depression.
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Affiliation(s)
- Kirsten Nørgaard
- Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.
| | - Urd Kielgast
- Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Zealand University Hospital, Køge, Denmark
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Gutefeldt K, Hedman CA, Thyberg ISM, Bachrach-Lindström M, Arnqvist HJ, Spångeus A. Upper extremity impairments in type 1 diabetes with long duration; common problems with great impact on daily life. Disabil Rehabil 2017; 41:633-640. [DOI: 10.1080/09638288.2017.1397202] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kerstin Gutefeldt
- Department of Endocrinology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Christina A. Hedman
- Department of Endocrinology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Ingrid S. M. Thyberg
- Department of Rheumatology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Margareta Bachrach-Lindström
- Division of Nursing Sciences, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Hans J. Arnqvist
- Department of Endocrinology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Anna Spångeus
- Department of Endocrinology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Bloomgarden Z. Upper extremity arthropathy in diabetes. J Diabetes 2017; 9:542-543. [PMID: 28374546 DOI: 10.1111/1753-0407.12557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Zachary Bloomgarden
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, USA
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Mouat IC, Morse ZJ, Jean-Baptiste VSE, Allanach JR, Horwitz MS. Fresh Ideas, Foundational Experiments (FIFE): Immunology and Diabetes 2016 FIFE Symposium. Front Endocrinol (Lausanne) 2017; 8:238. [PMID: 28974943 PMCID: PMC5610696 DOI: 10.3389/fendo.2017.00238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/30/2017] [Indexed: 12/16/2022] Open
Abstract
The first Fresh Ideas, Foundational Experiments (FIFE): Immunology and Diabetes symposia workshop took place in 2016 and exemplified the active interest of a number of several investigators interested the global rise in the incidence of type 1 diabetes (T1D). This increase does not correlate with genetic drift and indicates that environmental exposures are playing an increasingly significant role. Despite major biomedical and technological advances in diagnosis and treatment, treatments are frequently insufficient as they do not inhibit the progression of the underlying autoimmune response and often fail to prevent life-threatening complications. T1D is the result of autoimmune destruction of the insulin-producing beta cells of the pancreas, and the precise, mechanistic contribution of the immune system to disease pathogenesis and progression remains to be fully characterized. Ultimately, the combinatorial effect of concurrent factors, including beta cell fragility, exogenous stressors, and genetic priming of the innate and adaptive immune system, work together to induce T1D autoimmunity. Thus, T1D is the result of immunological defects and environmental pathogens, requiring the sustained attention of collaborative research teams such as FIFE: I & D with varied perspectives, unified by the universally held goal of finding a sustainable, life-long cure. Herein, the authors provide perspective on various fields in T1D research highlighted by speakers participating in the inaugural FIFE symposium.
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Affiliation(s)
- Isobel C. Mouat
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Zachary J. Morse
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | | | - Jessica R. Allanach
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Marc S. Horwitz
- Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
- *Correspondence: Marc S. Horwitz,
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