Title: Musculoskeletal Complications of Diabetes and Relation to Glycemic Control

Authors: Dr Jacob Antony, Dr Regi David Sam

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.104

Abstract

Background of study: Diabetes is a highly prevalent disease in India. There are many studies on microvascular and macrovascular complication of diabetes. Diabetes also predisposes to other complications like musculoskeletal and gastrointestinal complications. There are not many studies on the musculoskeletal complications of diabetes which produces significant morbidity for the patient. Hence we planned for this study on the musculoskeletal complication of diabetes. The aims of the study were to find out the prevalence of musculoskeletal complication of diabetes and its relation with duration and degree of glycaemic control.

Methods: The study was designed as a cross sectional observational study in the diabetic OPD setting of Thiruvananthapuram medical college. Institutional ethical committee clearance was obtained prior to starting the study. After meeting the inclusion and exclusion criterias, 150 consecutive diabetic patients attending the OPD were included in the study after getting informed consent. They were evaluated clinically for musculoskeletal complications. Basic biochemical tests were done at biochemistry lab, Thiruvananthapuram medical college. Data collected was analysed by SPSS software.

Results & Discussion: Prevalence of musculoskeletal complications were 44% (66 out of 150). Adhesive capsulitis was the most common musculoskeletal manifestation (35%). Shoulder hand syndrome and cheiropathy was present in 15.3% and 5.3% of the patients respectively. Dupuytrenes’ contracture (1.3%) and Charcot’s joint (0.7%) were infrequent. Further analysis revealed that the prevalence of musculoskeletal manifestations were more as the duration of diabetes increases. Among a total of 15 persons with history of DM for 15-20 years, 11 were having musculoskeletal manifestations. It was also seen that prevalence of complications were high in patients with higher HbA1c. Among the 7 persons with HbA1c more than 10%, six were having musculoskeletal manifestations.

Conclusion: Prevalence of musculoskeletal manifestations is high among diabetic patients attending OPD (>40%). Poor glycaemic control and longer duration of diabetes increases the prevalence of musculoskeletal manifestations.

Keywords: diabetes; musculoskeletal; prevalence; HbA1c ; adhesive capsulitis.

References

  1. International Diabetes Federation: IDF Diabetes Atlas Sixth Edition. 2013. Update 2014. www.idf.org/sites/default/files/ Atlas-poster-2014_EN.pdf (accessed December 22, 2015).
  2. India Diabetes Management Algorithm proposal group, A proposed India specific algorithm for management of type 2 Diabetes, Diabetes technology and therapeautics, 1-5,Volume 18, Number 5, 2016
  3. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes care 20:1183-1197, 1997.
  4. Expert Committee on the Diagnosis and classification of Diabetes Mellitus: Follow-up report Diabetes care 26:3160-3167, 2003.
  5. Standards of Medical Care in Diabetes—2010American Diabetes Association, Diabetes Care 2010 Jan; 33(Supplement 1): S11-S61
  6. American Diabetes Association: Consensus statement on self-monitoring of blood glucose. Diabetes Care 10:95-99,1987.
  7. American Diabetes Association: self-monitoring of blood glucose. Diabetes Care 17:81-86,1994.
  8. Sacks DB, Bruns DE, Goldstein DE, Maclaren NK, Mcdonald JM, Parrott M: Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. ClinChem 48:436-472,2002.
  9. Rohlfing CL, Wiedmeyer HM, Little RR, England JD, Tennill A, Goldstein DE: Defining the relationship between plasma glucose and HbA1C: Diabetes care 25:275-278,2002.
  10. The Diabetes Control and Complications Trial Research Group: N Engl J Med 329:977-986,1993.

Corresponding Author

Dr Regi David Sam

Assistant Professor, Government Medical College Thiruvananthapuram, Kerala

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