Highlights
- •Approximately half of type 2 diabetes mellitus individuals suffer from upper extremity musculoskeletal disorders.
- •Musculoskeletal disorders are prevalent bilaterally in thirty-two percent of individuals.
- •Limited joint mobility and frozen shoulder are the most prevalent disorders.
- •The proportion of limited joint mobility was more than frozen shoulder.
- •Amongst all disorders, frozen shoulder leads to maximum disability, followed by limited joint mobility and trigger finger.
Abstract
Study design
Cross-sectional
Introduction
Globally, diabetes is a leading cause of disability with an increased prevalence rate
in the past three decades. Chronic diabetes has been shown to affect collagenous tissue
which often leads to subsequent musculoskeletal complications. Despite increasing
prevalence of musculoskeletal disorders, the proportion and distribution of types
of upper extremity musculoskeletal disorders resulting in disabilities is poorly understood.
Purpose of the study
This cross-sectional study aims to gather data on the prevalence, proportion and distribution
of upper extremity musculoskeletal disorders among individuals with Type 2 Diabetes
Mellitus. Further, this study examines the relationship between common upper extremity
disorders and the resulting disability among individuals with Type 2 Diabetes Mellitus.
Methods
170 individuals diagnosed with Type 2 Diabetes Mellitus were recruited at a tertiary
care hospital. Routine upper extremity assessments were performed to identify the
presence of Frozen Shoulder (FS), Limited Joint Mobility (LJM), Trigger Finger, Carpal
Tunnel Syndrome (CTS), and Dupuytren's Contracture. Disability was measured using
the Disabilities of arm, shoulder, and hand (DASH) questionnaire. Descriptive statistics,
one-way analysis of variance, Tukey's test, and Pearson's test were used to examine
the prevalence, proportion and distribution of musculoskeletal disorders and disabilities
among individuals with type 2 Diabetes Mellitus.
Results
83(48.9%) participants had one or a combination of multiple musculoskeletal disorders
of the upper extremity. The proportion of LJM, FS, CTS, Trigger Finger, and Dupuytren's
Contracture were n = 46(27.1%); n = 43(25.3%); n = 16(9.4%); n = 8(4.7%); n = 5(2.9%) respectively. Disability scores on the DASH were 25.8 ± 14.5, 10.3 ± 11.9,
and 10.6 ± 10.4 respectively for individuals with FS, LJM and Trigger Finger. DASH
scores were highest in individuals with both CTS and FS, 29.8 ± 19.3. Duration of
diabetes was significantly associated (r = 0 .19; P < .01) with the disability scores on DASH.
Conclusion
The prevalence of musculoskeletal disorders in people with type 2 Diabetes mellitus
remains high despite advances in medical management over the last two decades. The
overall prevalence of hand disorders (LJM, CTS, Dupuytren's contracture, Trigger Finger)
was higher than shoulder disorders (FS), e.g. frozen shoulder. People with a diabetes
that had a diagnosed upper extremity conditon had more upper extremity disability,
than those with diabetes but no diagnosed hand condition, Disability was highest for
frozen shoulder and lowest for Dupuytren's diagnoses. Carpal tunnel syndrome was the
most disabling hand condition. People with diabetes should be screened for upper extremity
diagnoses that could limit their function. Poeple with disability resulting from hand
disorders was lower than the shoulder disorders. A combination of hand and shoulder
disorders resulted in greater disability.
Keywords
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JHT Read for Credit
Quiz: # 884
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.Chronic diabetes often contributes to musculoskeletal disorders because it
- a.deposits sugar crystals in joints
- b.alters blood flow to muscles
- c.affects collagenous tissue
- d.affects skin flexibility
- a.
- # 2.Disability was highest among those with
- a.frozen shoulder
- b.Dupuytren's
- c.lateral epicondylitis
- d.pronator syndrome
- a.
- # 3.Screening examinations noted
- a.trigger finger
- b.frozen shoulder
- c.carpal tunnel syndrome
- d.all of the above
- a.
- # 4.Which pathology was the most disabling
- a.swan neck
- b.Dupuytren's
- c.CTS
- d.cubital tunnel
- a.
- # 5.Disability was lowest for patients with Dupuytren's
- a.not true
- b.true
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: April 13, 2021
Accepted:
April 5,
2021
Received in revised form:
March 12,
2021
Received:
October 9,
2020
Footnotes
Funding: The study did not receive any funding.
Conflict of interest: All authors declare no conflict of interest.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
