Musculoskeletal manifestation of Diabetes Mellitus is highly prevalent and is associated with poor diabetic control
Kamil Khan, Kabir Ali, Muhammad Haroon
Division of Rheumatology, Department of Medicine, University Hospital Kerry, Tralee
Rheumatic manifestations of diabetes mellitus (DM), are frequently associated with functional disabilities.
The aim of our study was to review the different musculoskeletal manifestations in diabetic patients and the associated factors of these rheumatic manifestations.
The study participants were all consecutive pts attending endocrinology clinics of University Hospital Kerry for the management of their DM. Patients with chronic inflammatory arthritis or chronic autoimmune diseases were excluded. Only the joint pains lasting more than 3 months were studied, and were labelled as DM-related musculoskeletal (DM-MSK) symptoms and included (Stiff hands, Bilateral Frozen Shoulders, Carpel Tunnel Syndrome, Charcot joint). Number of clinical variables and end organ complications of DM were included. Moreover, personal history of cardiovascular risk factors and diseases were also recorded.
A total of 278 patients were studied and 250 patients [mean age 66±16 years; 58% male; mean duration of DM 13±10 years; mean BMI of 27.5±6] fulfilling the inclusion criteria were evaluated. DM-MSK symptoms were present in 37.6% (n=94) of the cohort. On Univariate analysis, patients with older age, type-2 DM, using hypoglycaemic agents, hypertension, ischemic heart disease, peripheral vascular disease, cerebrovascular accident, congestive heart disease, and patients with renal involvement had significantly higher prevalence of joint pains lasting >3 months. On multivariate analysis, poor diabetic control, diabetic kidney disease and increasing age were independently associated with DM-MSK symptoms.
DM-MSK symptoms are very common and are associated with poor diabetic control and its renal complications.