Background: The numbers of Diabetes Mellitus (DM) cases are increasing worldwide. DM cause chronic damage to many body organs. A number of musculoskeletal conditions have been linked to Diabetes Mellitus which include some affecting the shoulders (i.e. adhesive capsulitis and rotator cuff tendinopathy, carpal tunnel syndrome, neuropathic arthropathy), the hands (limited joint mobility, and diabetic sclerodactyly) and several other conditions. These health issues are important to identify because they can affect quality of life. The aim of this study was to identify these musculoskeletal conditions associated with Syrians type 2 diabetics. Participants & Methods: The study was conducted on 550 individuals, 300 of them were type 2 diabetics and 250 individuals were free of diabetes. Prior to the study, all patients were screened for diabetes and musculoskeletal abnormalities. A further assessment was done to those who had any musculoskeletal problem to find the exact diagnosis according to the criteria. Results and Discussion: Only 73 patients (24.3%) had controlled diabetes. Their HbA1c level was <8.1. 64% of diabetic patients had positive GALS screening examination comparing with 27.6% non-diabetic patients. Regarding to REM, results have shown that positive rheumatological conditions in 98 diabetic individuals comparing to 83 non-diabetic patients had a positive GALS screening. DISH was identified in 23 (6.7%) Patients, in comparison with 15 (6%) control or non-diabetics population. Conclusion: The prevalence of various musculoskeletal complications in type 2 diabetics is quite high. Controlling glucose levels in diabetics maybe considered an effective method to reduce the prevalence of such complications.
Cite this paper
Kudsi, M. and Labban, L. (2020). The Prevalence of Musculoskeletal Complications in Type 2 Diabetes Mellitus. Open Access Library Journal, 7, e6278. doi: http://dx.doi.org/10.4236/oalib.1106278.
Papanas, N. and Maltezos, E. (2010) The Diabetic Hand: A Forgotten Complication? Journal of Diabetes and Its Complications, 24, 154-162.
https://doi.org/10.1016/j.jdiacomp.2008.12.009
Chen, L.-H., Li, C.-Y. and Hou, W.-H. (2015) Risk of Hand Syndromes in Patients with Diabetes Mellitus. Medicine (Baltimore), 94, e1575.
https://doi.org/10.1097/MD.0000000000001575
Crispin, J.C. and Alcocer-Varela, J. (2003) Rheumatologic Manifestations of Diabetes Mellitus. American Journal of Medicine, 114, 753-757.
https://doi.org/10.1016/S0002-9343(03)00140-2
Bhat, T.A., Dhar, S.A., Dar, T.A., Naikoo, M.A., Naqqash, M.A., Bhat, A., et al. (2016) The Musculoskeletal Manifestations of Type 2 Diabetes Mellitus in a Kashmiri Population. International Journal of Health Sciences, 10, 57.
https://doi.org/10.12816/0031222
Font, Y.M., Castro-Santana, L.E., Nieves-Plaza, M., et al. (2014) Factors Associated with Regional Rheumatic Pain Disorders in a Population of Puerto Ricans with Diabetes Mellitus. Clinical Rheumatology, 33, 995-1000.
https://doi.org/10.1007/s10067-013-2474-1
Pi-Sunyer, F.X. (2000) Obesity: Criteria and Classification. Proceedings of the Nutrition Society, 59, 505-509. https://doi.org/10.1017/S0029665100000732
Lebiedz-Odrobina, D. and Kay, J. (2010) Rheumatic Manifestations of Diabetes Mellitus. Rheumatic Disease Clinics of North America, 36, 681-699.
https://doi.org/10.1016/j.rdc.2010.09.008
Roquelaure, Y., Ha, C., Rouillon, C., Fouquet, N., Leclerc, A., Descatha, A., et al. (2009) Risk Factors for Upper-Extremity Musculoskeletal Disorders in the Working Population. Arthritis Care & Research, 61, 1425-1434.
https://doi.org/10.1002/art.24740
Arkkila, P.E. and Gautier, J.F. (2003) Musculoskeletal Disorders in Diabetes Mellitus: An Update. Best Practice & Research: Clinical Rheumatology, 17, 945-970.
https://doi.org/10.1016/j.berh.2003.11.001
Balci, N., Balci, M.K. and Tüzüner, S. (1999) Shoulder Adhesive Capsulitis and Shoulder Range of Motion in Type II Diabetes Mellitus: Association with Diabetic Complications. Journal of Diabetes and its Complications, 13, 135-140.
https://doi.org/10.1016/S1056-8727(99)00037-9
Nair, J.B. and Pillai, S.S. (2011) Rheumatic-Musculoskeletal Manifestations in Type 2 Diabetes Mellitus Patients in South India. International Journal of Rheumatic Disease, 14, 55-60. https://doi.org/10.1111/j.1756-185X.2010.01587.x
Douloumpakas, I., Pyrpasopoulou, A., Triantafyllou, A., Sampanis, Ch. and Aslanidis, S. (2007) Prevalence of Musculoskeletal Disorders in Patients with Type 2 Diabetes Mellitus: A Pilot Study. Hippokratia, 11, 216-218.
Kameyama, M., Funae, O., Meguro, S. and Atsumi, Y. (2006) HbA1c Values Determine the Outcome of Intrasheath Injection of Triamcinolone for Diabetic Flexor Tenosynovitis. Diabetes Care, 29, 2512-2514. https://doi.org/10.2337/dc06-0852
Savas, S., K？ro？lu, B.K., Koyuncuo？lu, H.R., Uzar, E., Celik, H. and Tamer, N.M. (2007) The Effects of the Diabetes Related Soft Tissue Hand Lesions and the Reduced Hand Strength on Functional Disability of Hand in Type 2 Diabetic Patients. Diabetes Research and Clinical Practice, 77, 77-83.
https://doi.org/10.1016/j.diabres.2006.10.020
Alabdali, L.A.S., Jaeken, J., Dinant, G.-J. and Ottenheijm, R.P.G. (2019) Awareness of Limited Joint Mobility in Type 2 Diabetes in General Practice in the Netherlands: An Online Questionnaire Survey. BMC Family Practice, 20, 98.
https://doi.org/10.1186/s12875-019-0987-7
Rosenbloom, A.L., Silverstein, J.H., Lezotte, D.C., Richardson, K. and McCallum, M. (1981) Limited Joint Mobility in Childhood Diabetes Mellitus Indicates Increased Risk for Microvascular Disease. The New England Journal of Medicine, 305, 191-194. https://doi.org/10.1056/NEJM198107233050403
Silva, M.B.G. and Skare, T.L. (2012) Musculoskeletal Disorders in Diabetes Mellitus. Revista Brasileira de Reumatologia, 52, 594-609.
https://doi.org/10.1590/S0482-50042012000400010
Gerrits, E.G., Landman, G.W. and Bilo, H.J. (2015) Limited Joint Mobility Syndrome in Diabetes Mellitus: A Mini-Review. World Journal of Diabetes, 6, 1108- 1112. https://doi.org/10.4239/wjd.v6.i9.1108
Kidwai, S.S., Wahid, L. and Sheikh, I. (2013) Upper Limb Musculoskeletal Abnormalities in Type 2 Diabetic Patients in Low Socioeconomic Strata in Pakistan. BMC Research Note, 6, 16. https://doi.org/10.1186/1756-0500-6-16
Burner, T.W. and Rosenthal, A.K. (2009) Diabetes and Rheumatic Diseases. Current Opinion in Rheumatology, 21, 50-54.
https://doi.org/10.1097/BOR.0b013e32831bc0c4
Merashli, M., Chowdhury, T.A. and Jawad, A.S.M. (2015) Musculoskeletal Manifestations of Diabetes Mellitus. International Journal of Medicine, 108, 853-857.
https://doi.org/10.1093/qjmed/hcv106
Handa, A., Gotoh, M., Hamada, K., et al. (2003) Vascular Endothelial Growth Factor 121 and 165 in Subacromial Bursa Are Involved in Shoulder Joint Contracture in Type II Diabetes with Rotator Cuff Disease. Journal of Orthopaedic Research, 21, 1138-1144. https://doi.org/10.1016/S0736-0266(03)00102-5
Sarkar, P., Pain, S., Sarkar, R.N., Ghosal, R., Mandal, S.K. and Banerjee, R. (2008) Rheumatological Manifestations in Diabetes Mellitus. Journal of the Indian Medical Association, 106, 593-594.
Kidwai, S.S., Wahid, L. and Siddiqi, S.A. (2013) Upper Limb Musculoskeletal Abnormalities in Type 2 Diabetic Patients in Low Socioeconomic Strata in Pakistan. BMC Research Notes, 6, 16. https://doi.org/10.1186/1756-0500-6-16
Egede, L.E. (2004) Diabetes, Major Depression, and Functional Disability among U.S. Adults. Diabetes Care, 27, 421-428. https://doi.org/10.2337/diacare.27.2.421
Abate, M., Schiavone, C., Di Carlo, L. and Salini, V. (2012) Achilles Tendon and Plantar Fascia in Recently Diagnosed Type II Diabetes: Role of Body Mass Index. Clinical Rheumatology, 31, 1109-1113. https://doi.org/10.1007/s10067-012-1955-y
Milgrom, C., Novack, V., Weil, Y., Jaber, S., Radeva-Petrova, D.R. and Finestone, A. (2008) Risk Factors for Idiopathic Frozen Shoulder. The Israel Medical Association Journal, 10, 361-364.
Mavrikakis, M.E., Drimis, S. and Kontoyannis, D.A. (1989) Calcific Shoulder Periarthritis (Tendinitis) in Adult Onset Diabetes Mellitus: A Controlled Study. Annals of the Rheumatic Diseases, 48, 211-214. https://doi.org/10.1136/ard.48.3.211
Fatemi, A., Iraj, B., Barzanian, J., Maracy, M. and Smiley, A. (2015) Musculoskeletal Manifestations in Diabetic versus Prediabetic Patients. International Journal of Rheumatic Diseases, 18, 791-799. https://doi.org/10.1111/1756-185X.12712
