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Abebe G, Hailu T, Fikadu T, Gebremickael A, Temesgen R, Shibru T, Kefelew E, Dawit F, Atnafu K, Wale Tesega W, Bekele A. Magnitude and factors associated with musculoskeletal disorder among patients with diabetes attending chronic care at Arba Minch General Hospital, Arba Minch, southern Ethiopia, 2021: a cross-sectional study. BMJ Open 2022; 12:e059218. [PMID: 36343989 PMCID: PMC9644307 DOI: 10.1136/bmjopen-2021-059218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE This study aimed to assess the prevalence and determinants of musculoskeletal disorders (MSDs) among patients with diabetes in southern Ethiopia. DESIGN Facility-based cross-sectional study. SETTING Data collected from 1 March 2021 to 30 August 2021 at Arba Minch General Hospital. PARTICIPANTS Three hundred and sixty-five patients with diabetes attending care at Arba Minch General Hospital. MAIN OUTCOME MEASURES The magnitude and determinants of the MSDs. RESULTS The prevalence of MSDs among patients with diabetes was 23.29% (95% CI 19.00 to 27.76). The likelihood of developing MSDs was 6.8 times higher among women than men (AOR=6.787, 95% CI 2.08 to 22.19). Rural participants were about 2.4 times (AOR=2.38, 95% CI 1.06 to 5.33) more likely to develop MSDs as compared with urban participants. Participants aged >50 years were 5.9 times more likely to develop MSDs as compared with those aged ≤50 years (AOR=5.864, 95% CI 2.663 to 12.914). The odds of developing MSDs was 6.2 times (AOR=6.247, 95% CI 1.158 to 33.702) and 5.5 times (AOR=5.451 95% CI 1.174 to 25.312) higher among participants who attended primary and secondary education as compared with those who attended college and above, respectively. Participants with cardiovascular disease were 3.9 times more likely to develop MSDs as compared with their counterparts (AOR=3.854, 95% CI 1.843 to 8.063). CONCLUSIONS This study showed that age, sex, educational status, place of residence and cardiovascular disease were found to be determinants of MSDs. Thus, clinical and public health interventions working on diabetes mellitus should consider these determinants.
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Affiliation(s)
- Getachew Abebe
- Department of Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Tadiwos Hailu
- Department of Internal Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Teshale Fikadu
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- Department of nutrition and dietetics, Faculty of Public Health, Institute of Health, Jimma Jniversity, Jimma, Ethiopia
| | - Abinet Gebremickael
- Department of Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Rodas Temesgen
- Department of Internal Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Tamiru Shibru
- Department of Internal Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Etenesh Kefelew
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Firehiwot Dawit
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Kaleb Atnafu
- Department of Medical Laboratory, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Wondwossen Wale Tesega
- Department of Biomedical Science, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Alehegn Bekele
- Department of Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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Muacevic A, Adler JR, Jain V, Mannar V, Dalvi M. Diabetic Cheiroarthropathy in Type 1 Diabetes Mellitus and Coeliac Disease. Cureus 2022; 14:e31708. [PMID: 36561602 PMCID: PMC9767792 DOI: 10.7759/cureus.31708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2022] [Indexed: 11/22/2022] Open
Abstract
Diabetes mellitus can be associated with a variety of musculoskeletal disorders. Diabetic cheiroarthropathy or diabetic hand syndrome is one of the complications encountered in long-standing uncontrolled diabetes. It is characterized by limited movement of the joints of the hands along with thickening of the skin on the palmar and dorsal surfaces. There is an association between diabetic cheiroarthropathy and microvascular complications of diabetes, most commonly diabetic retinopathy. Early diagnosis of cheiroarthropathy can give the clinician an opportunity to screen for microvascular complications. Cheiroarthropathy is usually a clinical diagnosis. Treatment involves achievement of good glycemic control along with physiotherapy and occupational therapy. We have described the case of a 16-year-old adolescent male with uncontrolled type 1 diabetes and coeliac disease who presented to us with diabetic cheiroarthropathy.
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KAYMAZ S, AYKAN SA. The association between diabetes mellitus and functionality in knee osteoarthritis: a cross-sectional study. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1109130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: The aim of this study was to determine the roles of diabetes mellitus (DM) on quality of life, function of knee, and muscle strength in patients with knee osteoarthritis (OA).
Material and Method: This single-center, case-control study prospectively enrolled outpatients with knee OA visiting a physical therapy and rehabilitation clinic. The patients were grouped according to the presence of DM diagnosis. Demographic data, disease duration, and medical treatments of patients were recorded. Clinical parameters, radiographic grading (Kellgren-Lawrence grades), functional scales of the knee and quality of life were evaluated.
Results: The study included 82 participants [age: 61.3±6.7 years; female: 76.8%]. The mean Western Ontario and McMaster Universities Osteoarthritis Index of OA patients with (n=37) and without DM (n=45) were 45.79±18.04 vs. 65.94±16.23, respectively (p=0.003). The Hb A1c levels showed a negative correlation with Knee Injury and Osteoarthritis Outcome Score components (pain, quality of life, sports, daily activities, symptom duration) (p
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Bekele A, Abebe G, Hailu T, Fekadu T, Gebremickael A, Getachew T, Churko C, Alelign D, Wassihun B, Teshome D, Bukala Z. Prevalence and Associated Factors of Carpal Tunnel Syndrome Among Diabetic Patients in Arba Minch General Hospital, South West Ethiopia, 2021. Diabetes Metab Syndr Obes 2022; 15:983-993. [PMID: 35386587 PMCID: PMC8979567 DOI: 10.2147/dmso.s356484] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/12/2022] [Indexed: 12/20/2022] Open
Abstract
PURPOSE OF THE STUDY This study aimed to assess the prevalence of carpal tunnel syndrome and associated factors among diabetic patients in Arba Minch General Hospital, Southwest Ethiopia. Carpal tunnel syndrome (CTS) is the second most common cause of absence from work which causes functional loss of the hands and leads to disability. However, it is understudied among diabetic patients in Ethiopia. PATIENTS AND MATERIALS An institution-based cross-sectional study was conducted from May 1 to October 1, 2021. Systematic random sampling method was used to select 353 study participants. CTS-6 Evaluation tool was applied to assess carpal tunnel syndrome. The data was coded and entered into Epi-Data version 3.1 statistical packages and exported to SPSS version 25 for analysis. Binary logistic regression model was applied to assess the association between outcome variable and independent variables. Odds ratio (OR) with 95% CI and p-values <0.05 were used to identify significantly associated factors with an outcome variable. RESULTS The study was conducted among 353 diabetic patients. The cumulative prevalence of carpal tunnel syndrome among diabetes was 3.1%. CTS was statistically significantly associated with high body mass index; AOR=0.34 (0.12, 0.97, 95% CI) (p=0.04. Majority of participants 322 (91.2%) had type 2 DM. Mean fasting blood sugar level ± standard error of study participants was 157.52 ± 1.91 mg/dl. CONCLUSION The prevalence of carpal tunnel syndrome was relatively low. High body mass index (BMI) was significantly but negatively associated with carpal tunnel syndrome compared to diabetic patients with normal BMI. Diabetic patients with normal BMI should be screened for CTS for early management of the disease and prevention of further complications. Further investigations are recommended.
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Affiliation(s)
- Alehegn Bekele
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Correspondence: Alehegn Bekele, Department of Anatomy, Arba Minch University, P.O Box: 21, Arba Minch, Southern Nations, Nationalities and Peoples, Ethiopia, Tel +251921575427, Email
| | - Getachew Abebe
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tadiwos Hailu
- Department of Internal Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Teshale Fekadu
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Abinet Gebremickael
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tamiru Getachew
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Chuchu Churko
- Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Dagninet Alelign
- Department of Medical Laboratory, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Biresaw Wassihun
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Daniel Teshome
- Department of Anatomy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Zekarias Bukala
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Muluneh AG, Adem KS, Dawud JS, Kibret AK, Yitayal MM, Eriku GA. Upper-Extremity Musculoskeletal Disorders and Their Associated Factors Among Diabetes Mellitus Patients Attending at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Northwest Ethiopia: Cross-Sectional Study. Front Endocrinol (Lausanne) 2022; 13:856521. [PMID: 35557847 PMCID: PMC9086430 DOI: 10.3389/fendo.2022.856521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/03/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Globally, diabetes mellitus (DM) is a major public health, causing functional disability among those affected. Among the common diabetes mellitus-related complications, musculoskeletal disorders had a significant negative impact on the social health quality of life and productivity of individuals. Evidence in this regard, however, is scarce in Ethiopia. Therefore, this study aimed at determining the prevalence of musculoskeletal disorders and identifying factors associated in people with diabetes in Felege Hiwot Comprehensive Specialized Hospital, northwest Ethiopia. METHODS A cross-sectional study design was employed at Felege Hiwot Comprehensive Specialized Hospital from June 01 to August 30, 2020, among 413 participants. A systematic random sampling was employed to select the study participants. A structured, pretested questionnaire was used to collect data on socio-demographic, clinical, and lifestyle characteristics. Musculoskeletal disorders were assessed through clinical and physical examination. A logistic regression model was used to explore factors associated with musculoskeletal disorders. RESULT The prevalence of musculoskeletal disorders among diabetes mellitus patients was 24% (95% CI 20, 28.3). In logistic regression, factors such as being female, older age, occupation (farmer, merchant, and retired), and long duration of diabetes were significantly associated with musculoskeletal disorders. CONCLUSION Nearly one quarter of the study participants had musculoskeletal disorders. Special attention should be given for those individuals living with diabetes mellitus, particularly for those who are female, are older, and had a prolonged history of diabetes mellitus.
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Affiliation(s)
- Assefa Gebeyehu Muluneh
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Kedir Sany Adem
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Jemal Suleyman Dawud
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemu Kassaw Kibret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melisew Mekie Yitayal
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getachew Azeze Eriku
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- *Correspondence: Getachew Azeze Eriku,
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Kamiab Z, Shafaee N, Askar PS, Abbasifard M. Prevalence and Prevention of Rheumatologic Manifestations and their Relationship with Blood Glucose Control in Patients with Type II Diabetes. Int J Prev Med 2021; 12:142. [PMID: 34912518 PMCID: PMC8631128 DOI: 10.4103/ijpvm.ijpvm_369_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 05/18/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Musculoskeletal disorders in diabetic patients are associated with pain and disability, and thus, a significant reduction in quality of life. The current study was conducted with the aim of evaluating the frequency and prevention of rheumatologic manifestations and their association with blood glucose levels in diabetic patients. Methods: In this cross-sectional study, a total of 273 patients with type II diabetes, referred to the diabetes clinic, were selected by using the census method. Using a checklist, demographic, and clinical data, including duration of diabetes, blood glucose level, HbA1c, type of diabetes, BMI, history of smoking, blood pressure, serum cholesterol level, triglyceride, HDL, LDL, and musculoskeletal disorder type were analyzed using SPSS20 software application using independent t-test. Modeling was performed to obtain the best fit using logistic regression. The significance level was considered less than 0.05. Results: 62.6% of patients had at least one of the rheumatologic complications. The most common complication was related to carpal tunnel syndrome (26.4%), followed by muscle contraction (23.8%). By moderating the effects of other variables, the odds ratio for rheumatoid complications was obtained as 1.74 with one unit of increase in HbA1c, which was statistically significant. In examining the influential variables, high age, gender, smoking, and BMI showed statistically significant effects (). Conclusions: Given the high prevalence of musculoskeletal disorders in diabetic patients, early diagnosis and timely treatment of the complications are crucial. It is recommended that musculoskeletal examinations be included as an important part of regular care for these patients.
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Affiliation(s)
- Zahra Kamiab
- Department of Family Medicine, School of Medicine, Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Negar Shafaee
- General Physician, Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Poya Saied Askar
- Medical Student, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mitra Abbasifard
- Department of Internal Medicine, School of Medicine; Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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AlOayan LI, Zawawi AH. Musculoskeletal manifestations among diabetic patients in Saudi Arabia. J Family Med Prim Care 2021; 9:5597-5600. [PMID: 33532401 PMCID: PMC7842468 DOI: 10.4103/jfmpc.jfmpc_654_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/10/2020] [Accepted: 06/17/2020] [Indexed: 11/06/2022] Open
Abstract
Context: Diabetes mellitus (DM) is one of the most common diseases worldwide. Patients with DM are prone to develop multiple musculoskeletal (MSK) manifestations, which may lead to disability and an impact on patients’ quality of life. These manifestations include but not limited to, adhesive capsulitis, shoulder hand syndrome, diabetic hand syndrome, diffuse idiopathic skeletal hyperostosis, Dupuytren's contracture. Aims: The aim of this study is to assess the prevalence of MSK manifestations in diabetic patients in Saudi Arabia. Settings and Design: The study was carried out in NGHA hospital and PHC in Saudi Arabia. Methods and Materials: This is a retrospective study carried out between 2015 and 2019 where all patients with DM type II between the age of 18 and 65 and were diagnosed with MSK manifestations included in the study. Statistical Analysis Used: Statistical Package for the Social Sciences (IBM-SPSS) software (Version 23). Results: A total of 208 patients were found to have MSK manifestations. The average age of patients was 53 years old ranging from (31-63). The mean reading of A1C was 8%. A total of 34.1% were controlled and 65.9% were uncontrolled. Carpal tunnel syndrome (CTS) was found in 10%. Adhesive capsulitis in 2.4%. Septic arthritis in 1%. Trigger finger was found in 7.2%. Osteomyelitis was found in 0.5%. Plantar fasciitis was found in 4.8%. Osteoarthritis (OA) was found in 149 subjects (71.3%). Two subjects had ankle OA, one hand OA, nine shoulder OA, one hip arthritis. The rest had knee OA. Rotator cuff tendonitis was found in 1%. No significant correlation between age, A1c and all the MSK manifestations that were mentioned above (P value >0.05). Conclusions: MSK manifestations are common among diabetic patients. OA was the most frequently seen disorder. Physicians should be aware of the high prevalence and the huge impact on patients when treating patients with type II DM.
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Affiliation(s)
- Laura I AlOayan
- Department of Family Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Department of Family Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Alia H Zawawi
- Department of Family Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Department of Family Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
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Priesand SJ, Schmidt BM, Ang L, Wrobel JS, Munson M, Ye W, Pop-Busui R. Plantar fasciitis in patients with type 1 and type 2 diabetes: A contemporary cohort study. J Diabetes Complications 2019; 33:107399. [PMID: 31279734 PMCID: PMC6932628 DOI: 10.1016/j.jdiacomp.2019.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/09/2019] [Accepted: 06/11/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Hyperglycemia leads to increase advanced glycation end products (AGEs) in patients with type 1 and type 2 diabetes. Subsequently, formation of AGEs can cause increased plantar fascial thickness (PFT), an imaging feature of plantar fasciitis (PF). This study evaluates the prevalence of PF in a contemporary cohort of type 1 diabetes and type 2 diabetes patients managed according to current standards, compared to patients without diabetes. RESEARCH DESIGN AND METHODS This is a five-year prevalence study in a large tertiary health system (approximately 535,000 patients/visits/year) with a single electronic medical record (EMR), applying a cohort discovery tool and database screen (Data Direct) with use of ICD-9 and ICD-10 codes. All patients with a PF diagnosis between 01/01/2011 and 01/01/2016 were included and divided into 3 groups: type 1 diabetes (7148 patients), type 2 diabetes (61,632 patients), and no diabetes (653,659 patients). Prevalence rates were calculated, accounting for other risk factors including BMI and gender using Fisher's exact test. RESULTS The overall prevalence of PF in the entire study population was 0.85%. Prevalence rates were higher in patients with diabetes, particularly with type 2 diabetes (42% and 64% higher compared with patients with type 1 diabetes and no diabetes respectively). Individually, PF rates were 0.92% in type 1 diabetes and 1.31% in type 2 diabetes compared with 0.80% in patients with no diabetes (Type 1 vs. no diabetes p = 0.26; Type 2 vs. no diabetes p ≪ 0.0001; Type 1 vs. Type 2 diabetes p = 0.0054). Females in all groups had higher prevalence of PF than males (p ≪ 0.0001 for all), with those patients with diabetes having higher prevalence rates than those without diabetes. Patients with higher BMI levels (BMI ≥ 30 kg/m2) were also more likely to have PF in all categories except males with type 1 diabetes (p = 0.40). CONCLUSIONS In this large contemporary population managed in a tertiary health system, prevalence rates of PF were substantially higher in patients with diabetes compared with no diabetes, particularly in type 2 diabetes. Female gender and higher BMI were also associated with higher prevalence of PF in this cohort.
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Affiliation(s)
- Sari J Priesand
- Michigan Medicine, Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, Domino's Farms (Lobby C, Suite 1300) 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, United States of America.
| | - Brian M Schmidt
- Michigan Medicine, Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, Domino's Farms (Lobby C, Suite 1300) 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, United States of America.
| | - Lynn Ang
- Michigan Medicine, Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, Domino's Farms (Lobby C, Suite 1300) 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, United States of America
| | - James S Wrobel
- Michigan Medicine, Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, Domino's Farms (Lobby C, Suite 1300) 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, United States of America
| | - Michael Munson
- Michigan Medicine, Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, Domino's Farms (Lobby C, Suite 1300) 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, United States of America
| | - Wen Ye
- The University of Michigan, School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America
| | - Rodica Pop-Busui
- Michigan Medicine, Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, Domino's Farms (Lobby C, Suite 1300) 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106, United States of America
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Alabdali LAS, Jaeken J, Dinant GJ, Ottenheijm RPG. Awareness of limited joint mobility in type 2 diabetes in general practice in the Netherlands: an online questionnaire survey. BMC FAMILY PRACTICE 2019; 20:98. [PMID: 31288736 PMCID: PMC6615429 DOI: 10.1186/s12875-019-0987-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 07/01/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Next to the well-known micro- and macrovascular complications, type 2 diabetes mellitus (T2DM) is associated with musculoskeletal disorders of the upper extremities referred to as limited joint mobility (LJM), e.g. carpal tunnel syndrome (CTS) and adhesive capsulitis. Unrecognized and untreated LJM can lead to poor quality of life and non-compliance to diabetes treatment which aggravates LJM. Despite its reported higher prevalence in international prevalence studies, examination of the upper extremities is still no part of the regular diabetes mellitus (DM) check-ups. The primary aim of this study was therefore to evaluate the awareness of Dutch GPs and nurse practitioners concerning LJM. Secondary aims were to evaluate the current management of a patient with LJM, and to assess opinions regarding the question of who should screen for LJM if this is done in the near future. METHODS An online survey was conducted among 390 general practitioners (GPs) and 245 nurse practitioners (NPs) of three diabetes care groups in The Netherlands to assess their awareness of the association between DM and LJM. RESULTS Most GPs are not aware that LJM is a DM complication, with an unawareness for specific upper extremity disorders ranging from 59 to 73%. Of the NPs, 76% is not aware either. Only 41% of GPs would advise the most optimal treatment for diabetes patient with CTS. Finally, only 25% of the GPs believe that screening for LJM should be performed during the regular diabetes check-up compared to 63% of the NPs. CONCLUSION The majority of GPs and NPs are not aware of LJM as a T2DM complication. In contrast to NPs, most GPs do not believe that screening for LJM should be performed during the regular diabetes check-up.
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Affiliation(s)
- Login Ahmed S Alabdali
- Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands.
| | - Jasmien Jaeken
- ICHO, the Centre of Family Medicine, Catholic University, Leuven, Belgium
| | - Geert-Jan Dinant
- Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands
| | - Ramon P G Ottenheijm
- Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands
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Lung BE, Bisogno M, Kanjiya S, Komatsu DE, Wang ED. Early postoperative complications and discharge time in diabetic patients undergoing total shoulder arthroplasty. J Orthop Surg Res 2019; 14:9. [PMID: 30621737 PMCID: PMC6325881 DOI: 10.1186/s13018-018-1051-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 12/27/2018] [Indexed: 01/16/2023] Open
Abstract
PURPOSE With the increasing elderly population and obesity epidemic, diabetes is an important factor in arthroplasty planning. Although research suggests diabetes is associated with increased postoperative morbidity after hip and knee replacement, the effect of diabetes and varying management with insulin versus non-insulin agents on total shoulder arthroplasty (TSA) is not established. METHODS All TSAs from 2015 to 2016 were queried from the American College of Surgeons National Surgical Quality Improvement Program database. Age, gender, BMI, steroid, ASA, operative time, and smoking status were compared between all diabetics, diabetics on insulin, diabetics on non-insulin agents, and non-diabetics to account for confounding variables. Thirty-day postoperative complications, readmission rate, surgical site infection (SSI), and non-routine discharge to rehabilitation were compared using bivariate and multivariate binary logistic regression. Postoperative time to discharge between diabetic groups was analyzed using univariate ANOVA with Tukey's test. RESULTS The analysis included 7246 patients (insulin in 5% (n = 380), non-insulin in 13% (n = 922), and non-diabetics in 82% (n = 5944)). Diabetics were more likely to have an ASA ≥ 3 compared to non-diabetics (89.5% vs 50.1%; p < 0.001). Bivariate logistic regression showed statistical significance in readmission and non-routine discharge between all diabetics and non-diabetics (OR 1.7, 1.4; p = 0.001, 0.001), but there was no significance between SSI rate (0.3% vs 0.4%; p = 0.924). Multivariate logistic regression between groups showed significance in readmission between non-insulin diabetics vs non-diabetics (OR 1.5; p = 0.027), readmission and non-routine discharge in insulin vs non-diabetics (OR 2.1, 1.7; p = 0.003, < 0.001), and no significance between insulin and non-insulin diabetics. Postoperative days to discharge were 2.4, 2.0, and 1.8 days in insulin, non-insulin, and non-diabetics respectively. Mean differences were significant between all groups. CONCLUSIONS Diabetic patients are at a higher risk for readmission and non-routine discharge compared to non-diabetics. Despite no increased risk in SSI, longer postoperative discharge time in diabetics should be considered in TSA planning. TRIAL REGISTRATION Not applicable LEVEL OF EVIDENCE: Level III, case-control study.
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Affiliation(s)
- Brandon E. Lung
- School of Medicine, Stony Brook University, Stony Brook, NY USA
| | - Michael Bisogno
- Department of Orthopaedics, Stony Brook University Medical Center, HSC T-18, Room 080, Stony Brook, NY 11794-8181 USA
| | - Shrey Kanjiya
- Department of Orthopaedics, Stony Brook University Medical Center, HSC T-18, Room 080, Stony Brook, NY 11794-8181 USA
| | - David E. Komatsu
- Department of Orthopaedics, Stony Brook University Medical Center, HSC T-18, Room 080, Stony Brook, NY 11794-8181 USA
| | - Edward D. Wang
- Department of Orthopaedics, Stony Brook University Medical Center, HSC T-18, Room 080, Stony Brook, NY 11794-8181 USA
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Okur SC, Dogan YP, Mert M, Aksu O, Burnaz O, Caglar NS. Ultrasonographic Evaluation of Lower Extremity Entheseal Sites in Diabetic Patients Using Glasgow Ultrasound Enthesitis Scoring System Score. J Med Ultrasound 2018; 25:150-156. [PMID: 30065480 PMCID: PMC6029304 DOI: 10.1016/j.jmu.2017.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 03/01/2017] [Indexed: 01/15/2023] Open
Abstract
Objective The prevalence of musculoskeletal complications in diabetes mellitus (DM) increases with the duration of disease and with poor glycemic control. Our aim was to evaluate lower extremity musculoskeletal complications in patients with DM using the Glasgow Ultrasound Enthesitis Scoring System, and to reveal the relationship between clinical and sono-graphic findings. Materials and methods A total of 67 patients (25 men, 42 women) with DM were included in the study. All the diabetic patients were selected if they did not have any symptom of muscu-loskeletal system in the lower extremities. They were divided into four groups. Ultrasonographic assessment was performed according to the Glasgow Ultrasound Enthesitis Scoring System with an Esaote MyLab 5 device equipped with a 5-13 MHz linear transducer. Correlation between diabetes duration and lower extremity enthesopathy scores were evaluated. Results There was a significant correlation between duration of DM and total Glasgow Ultrasound Enthesitis Scoring System scores (p < 0.001). In addition, duration of DM was significantly correlated with enthesophyte scores and erosion scores (both p < 0.001). There was a significant difference among Groups 1 -4 for the mean enthesophyte score and mean erosion score (both, p < 0.001). Conclusion Musculoskeletal ultrasonography is an effective, inexpensive, and useful tool without radiation for evaluating diabetic patients for the early diagnosis of musculoskeletal complications.
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Affiliation(s)
- Sibel Caglar Okur
- Physical Medicine and Rehabilitation Unit, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Yasemin Pekin Dogan
- Physical Medicine and Rehabilitation Unit, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Murat Mert
- Department of Orthopedics and Traumatology, Yeni Yüzyıl University, Istanbul, Turkey
| | - Ozge Aksu
- Physical Medicine and Rehabilitation Unit, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Ozer Burnaz
- Physical Medicine and Rehabilitation Unit, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Nil Sayiner Caglar
- Physical Medicine and Rehabilitation Unit, Istanbul Training and Research Hospital, Istanbul, Turkey
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Musculoskeletal Disorders in Patients with Diabetes Mellitus: A Cross-Sectional Study. Int J Rheumatol 2018; 2018:3839872. [PMID: 30018643 PMCID: PMC6029479 DOI: 10.1155/2018/3839872] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/11/2018] [Accepted: 05/17/2018] [Indexed: 12/12/2022] Open
Abstract
Introduction A variety of musculoskeletal disorders (MS) have been associated with diabetes mellitus (DM). This study aimed at assessing the prevalence and associated factors of MS disorders in Moroccan diabetic patients. Methods A cross-sectional study enrolled consecutive patients with DM. We recorded demographic features of patients and characteristics of DM. MS disorders and vascular complications were assessed by clinical examinations and investigations. Associated factors of MS disorders were assessed by univariate and multivariate analyses. Result 376 subjects were included; 84.6% had type 2 DM. The participants' median age was 54 years [45-62]; 41% had one or more vascular complications. 34.4% had one or more MS disorders. Osteoarthritis was present in 19.4% of patients. Hand disorders were seen in 14.4%. Shoulder capsulitis was present in 12.5%. Long duration of diabetes and dyslipidemia were associated with increased prevalence of hand abnormalities (P = 0.017; P = 0.019, respectively). Age and dyslipidemia were associated with shoulder capsulitis (P = 0.019; P = 0.047, respectively). Female gender, overweight, and nephropathy were associated with increased odds of osteoarthritis (P = 0.009, P = 0.004, and P = 0.032, respectively). Conclusion MS disorders are frequent in this population and associated with various factors. HbA1c level does not appear to be associated with development of MS disorders.
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Reddy NJ, Mahesh M, Mamatha S, Madhumitha M. Rheumatological manifestation of diabetes: “Namaste” sign. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2018. [DOI: 10.4103/jdrntruhs.jdrntruhs_108_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Pons-Villanueva J, Escalada San Martín J. The stiff shoulder in diabetic patients. Int J Rheum Dis 2016; 19:1226-1236. [DOI: 10.1111/1756-185x.12890] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Juan Pons-Villanueva
- Department of Orthopedic Surgery and Traumatology; Clínica Universidad de Navarra; Pamplona Spain
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15
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Zreik NH, Malik RA, Charalambous CP. Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence. Muscles Ligaments Tendons J 2016; 6:26-34. [PMID: 27331029 PMCID: PMC4915459 DOI: 10.11138/mltj/2016.6.1.026] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND adhesive capsulitis (AC) results in progressive painful restriction in range of movement and can reduce function and quality of life. Whilst it has been associated with diabetes mellitus (DM), there is considerable variation in the reported prevalence of AC in the diabetic population. The aim of this study is to determine through meta-analysis the prevalence of AC in DM and examine whether it is influenced by type of DM or insulin therapy. We also aim to further establish the prevalence of DM in patients presenting with AC. METHODS we conducted a literature search for terms regarding AC and DM on Embase and Pubmed NCBI. RESULTS of 5411 articles identified, 18 were selected. Meta-analysis showed that patients with DM were 5 (95% CI 3.2-7.7) times more likely than controls to have AC. The overall prevalence of AC in DM was estimated at 13.4% (95% CI 10.2-17.2%). Comparison of prevalence in patients on insulin vs other treatments showed no significant difference between the two. Meta-analysis estimated the prevalence of DM in AC at 30% (95% CI 24-37%). CONCLUSION to our knowledge this is the first meta-analysis to estimate the overall prevalence of diabetes in a population with AC. A high prevalence of AC exists in DM and equally a high prevalence of DM is present in AC. Screening for DM should be considered in patients presenting with AC.
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Affiliation(s)
- Nasri Hani Zreik
- Department of Orthopaedics, Blackpool Victoria Hospital, Blackpool, UK
| | - Rayaz A. Malik
- Weill Cornell Medical College, Doha, Qatar
- Centre for Endocrinology & Diabetes, Institute of Human Development, University of Manchester, Manchester, UK
| | - Charalambos P. Charalambous
- Department of Orthopaedics, Blackpool Victoria Hospital, Blackpool, UK
- School of Medicine, University of Central Lancashire, Preston, UK
- Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK
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Fatemi A, Iraj B, Barzanian J, Maracy M, Smiley A. Musculoskeletal manifestations in diabetic versus prediabetic patients. Int J Rheum Dis 2015; 18:791-9. [PMID: 26176709 DOI: 10.1111/1756-185x.12712] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIM This study was carried out to evaluate the prevalence of musculoskeletal manifestations in a sample of patients with diabetes mellitus (DM) and those with prediabetes and compare the findings between the two groups. METHODS One hundred and eighty-eight patients with DM and 125 prediabetic subjects were randomly enrolled in this cross-sectional study. Demographic data and past history were recorded. Musculoskeletal physical examinations were done by a single rheumatologist. Regression analyses were employed to assess the crude and adjusted effects of determinants on DM musculoskeletal manifestations (DMMMs). RESULTS Female/male ratio was not significantly different between diabetic and prediabetic patients (4.4 vs. 4.7, respectively, P = 0.9). However, diabetic patients were significantly older than the prediabetic ones (56.6 vs. 52 years, respectively, P = 0.0001); 83.5% of diabetic patients and 52.8% of prediabetic ones had at least one musculoskeletal manifestation (P = 0.0001). The prevalence of knee osteoarthritis and shoulder involvement were almost two times more common (P = 0.0001 and P = 0.015) in diabetic patients than in prediabetic ones (73.4% vs. 38% and 21.2% vs. 9.5%, respectively). Prevalence of carpal tunnel syndrome (CTS) was 48% and 36.5% in patients with diabetes and prediabetes, respectively (P = 0.053). Multivariate backward regression analysis showed age, sex, BMI (body mass index) and DM as the significant determinants in development of musculoskeletal manifestations in all subjects. Age and BMI were the only significant factors associated with musculoskeletal manifestations in both diabetic and prediabetic patients. CONCLUSION Diabetic and prediabetic patients may show high prevalence of musculoskeletal manifestations. In non-diabetic patients diagnosed with CTS, prediabetes might be ruled out.
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Affiliation(s)
- Alimohammad Fatemi
- Department of Rheumatology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bijan Iraj
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jafar Barzanian
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Maracy
- Department of Biostatistics & Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Smiley
- Department of Biostatistics & Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran
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Abourazzak FE, Akasbi N, Houssaini GS, Bazouti S, Bensbaa S, Hachimi H, Ajdi F, Harzy T. Articular and abarticular manifestations in type 2 diabetes mellitus. Eur J Rheumatol 2014; 1:132-134. [PMID: 27708897 DOI: 10.5152/eurjrheumatol.2014.140050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Accepted: 07/16/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Diabetes mellitus (DM), a worldwide high-prevalence disease, is associated with a large variety of rheumatic manifestations. It affects the connective tissues in many ways and causes alterations in the periarticular and the musculoskeletal systems. In most cases, these manifestations are associated with functional disability and pain, affecting the quality of life of the diabetic patient. The aim of our study is to review the different articular and abarticular manifestations in diabetic patients and the associated factors of these rheumatic manifestations. MATERIAL AND METHODS A cross-sectional study that includes all patients suffering from type 2 DM who present with articular or abarticular manifestations. RESULTS We included 116 diabetic patients presenting with articular or abarticular manifestations. Our study showed four important findings. First, a large variety of articular and abarticular manifestations were present in patients with type 2 DM. Second, osteoarthritis (OA) of the knee was the most frequent articular manifestations. It was seen in 49% of our patients. Third, the most common manifestations in diabetic Moroccan patients were carpal tunnel syndrome (CTS), adhesive capsulitis of the shoulder, and diabetic cheiroarthropathy (29%, 23%, and 16%, respectively). Fourth, there was a significant association between vascular complications and the development of articular and abarticular manifestations. CONCLUSION This study shows that the articular and abarticular manifestations in diabetic Moroccan patients are dominated by CTS, adhesive capsulitis of the shoulder, and diabetic cheiroarthropathy, with a significant association between vascular complications and the development of some of these manifestations.
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Affiliation(s)
| | - Nessrine Akasbi
- Department of Rheumatology, Hassan II University Hospital, Fez, Morocco
| | | | - Sabah Bazouti
- Department of Rheumatology, Hassan II University Hospital, Fez, Morocco
| | - Salma Bensbaa
- Department of Endocrinology, Hassan II University Hospital, Fez, Morocco
| | - Hicham Hachimi
- Department of Rheumatology, Hassan II University Hospital, Fez, Morocco
| | - Farida Ajdi
- Department of Endocrinology, Hassan II University Hospital, Fez, Morocco
| | - Taoufik Harzy
- Department of Rheumatology, Hassan II University Hospital, Fez, Morocco
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Diabetic cheiroarthropathy: a case report and review of the literature. Case Rep Endocrinol 2013; 2013:257028. [PMID: 23762663 PMCID: PMC3671228 DOI: 10.1155/2013/257028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 04/27/2013] [Indexed: 11/17/2022] Open
Abstract
Diabetes mellitus is associated with a wide variety of rheumatologic manifestations which can significantly affect a patient's quality of life. One of these manifestations includes diabetic cheiroarthropathy (DCA) which affects the hands. We review a case of a 28-year-old female patient with type 1 diabetes mellitus who was diagnosed with DCA after complaining of limited movements of all joints in her hands and tightening of the skin. We examine how the diagnosis was made, the treatment administered, and the successful clinical outcome. Clinicians should be able to identify and treat this affliction. The diagnosis is mainly clinical. It is imperative to remember that the presence of DCA carries with it a significant relationship with microvascular disease.
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Attar SM. Musculoskeletal manifestations in diabetic patients at a tertiary center. Libyan J Med 2012; 7:19162. [PMID: 23115579 PMCID: PMC3484174 DOI: 10.3402/ljm.v7i0.19162] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 10/01/2012] [Indexed: 12/31/2022] Open
Abstract
Objectives Diabetes mellitus is a major public health problem worldwide. Most diabetic patients will develop functional disabilities due to multiple factors, including musculoskeletal (MSK) manifestations. The purpose of this study was to determine the frequency of MSK in diabetic patients and to examine the possible predictors for its development. Methods We performed a cross-sectional study from June 1, 2010, to June 30, 2011, to evaluate MSK manifestations in adult diabetic patients at an outpatient clinic of King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Baseline variables were examined to determine predictors for the development of MSK complications. Analyses were carried out using the Statistical Package for Social sciences. Results We included 252 diabetic patients; 45 (17.9%) had MSK manifestations. Of these 45 patients, 41 (91.1%) had type 2 diabetes. The most common manifestations were carpal tunnel syndrome (n=17, 6.7%), shoulder adhesive capsulitis (n=17, 6.7%), and diabetic amyotrophy (n=12, 4.8%). A significant association was found between the development of MSK manifestations and manual labor, overweight, and vascular complications. On logistic regression analysis, the presence of vascular complications in general (B-coefficient=1.27, odds ratio=3.57, P<0.05, 95% confidence interval=1.31–9.78), and retinopathy in particular (B-coefficient=1.17, odds ratio=3.21, P<0.05, 95% confidence interval=1.47–7.02) can predict the development of MSK manifestations in about 82% of the cases. Conclusion Musculoskeletal manifestations are under recognized in adult diabetic patients, occurring in 18% of the cases. Physicians should consider examining the periarticular region of the joints in the hands and shoulders whenever a diabetic patient presents with MSK symptoms.
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Affiliation(s)
- Suzan M Attar
- Department of Internal Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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