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 HbA_1c. Among the 7 persons with HbA_1c 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; HbA_1c ; adhesive capsulitis.