Frequency of Upper Limb Musculoskeletal Manifestations in 188 Type 2 Diabetic Patients, Referring to Diabetes Clinic of Firouzgar Hospital, 2011

With increasing prevalence of type 2 diabetes mellitus, a chronic disabling disease, we are facing to its more complications. Musculoskeletal problems that are usually neglected in diabetes management may be associated with a considerable pain, morbidity and disability. The aim of this study was to access the frequency of musculoskeletal manifestations of upper limb in type 2 diabetics and to determine its possible risk factors. A group was identified of 188 people with established type 2 diabetes attending the diabetes clinic in Firouzgar hospital, Tehran. Complete rheumatologic examination was done for all patients focusing on the upper limbs. Demographic characteristics, the mean 1-year HbA1c and the presence of diabetic nephropathy and retinopathy were recorded from patients registry documents. Frequency of musculoskeletal complications was determined. Correlation of baseline characteristics with rheumatologic complications was also assessed to determine the risk factors. Upper limb musculoskeletal disease was present in 48.4% (91 patients) of diabetics. Dupuytren’s contracture 20.2% (38 patients), trigger finger 18.1% (34 patients), limited joint mobility (LJM) 18.6% (35 patients), carpal tunnel syndrome 8% (15 patients), rotator cuff tendinitis 8% (15 patients), and shoulder capsulitis 6.9% (13 patients) were the most frequent findings. No relation was found between mean 1-year HbA1c and frequency of rheumatologic complications. Presence of diabetic retinopathy, older age, and duration of diabetes were risk factors for musculoskeletal involvement. Only 6% of patients (11 cases) were aware of diabetes musculoskeletal complications. Upper limb musculoskeletal complications were observed in about 50 percent of patients. Age, duration of diabetes, and retinopathy were major risk factors for musculoskeletal complications. Patients’ awareness of these complications was very low.