Abstract
BackgroundNext to the well-known micro- and macrovascular complications, type 2 diabetes mellitus (T2DM) is associated with musculoskeletal disorders of the upper extremities referred to as limited joint mobility (LJM), e.g. carpal tunnel syndrome (CTS) and adhesive capsulitis. Unrecognized and untreated LJM can lead to poor quality of life and non-compliance to diabetes treatment which aggravates LJM. Despite its reported higher prevalence in international prevalence studies, examination of the upper extremities is still no part of the regular diabetes mellitus (DM) check-ups. The primary aim of this study was therefore to evaluate the awareness of Dutch GPs and nurse practitioners concerning LJM. Secondary aims were to evaluate the current management of a patient with LJM, and to assess opinions regarding the question of who should screen for LJM if this is done in the near future.MethodsAn online survey was conducted among 390 general practitioners (GPs) and 245 nurse practitioners (NPs) of three diabetes care groups in The Netherlands to assess their awareness of the association between DM and LJM.ResultsMost GPs are not aware that LJM is a DM complication, with an unawareness for specific upper extremity disorders ranging from 59 to 73%. Of the NPs, 76% is not aware either. Only 41% of GPs would advise the most optimal treatment for diabetes patient with CTS. Finally, only 25% of the GPs believe that screening for LJM should be performed during the regular diabetes check-up compared to 63% of the NPs.ConclusionThe majority of GPs and NPs are not aware of LJM as a T2DM complication. In contrast to NPs, most GPs do not believe that screening for LJM should be performed during the regular diabetes check-up.
Highlights
To the well-known micro- and macrovascular complications, type 2 diabetes mellitus (T2DM) is associated with musculoskeletal disorders of the upper extremities referred to as limited joint mobility (LJM), e.g. carpal tunnel syndrome (CTS) and adhesive capsulitis
The most commonly observed specific LJM disorders are trigger finger, Dupuytren’s contracture, carpal tunnel syndrome (CTS) and Alabdali et al BMC Family Practice (2019) 20:98 adhesive capsulitis [13,14,15,16,17,18,19,20,21,22,23]. The prevalence of these disorders is lower in unselected populations: for adhesive capsulitis, 2–5% compared to 5–30% in patients with DM; for trigger finger, 1–2% compared to 5– 15%; Dupuytren’s contracture 13% vs 20–63%; and CTS 3.8% vs 25% [24,25,26,27,28]
A cross-sectional descriptive survey to assess General practitioner (GP)’ and Nurse practitioner (NP)’ awareness of common DM complications and comorbidities, awareness of LJM as a DM complication, management in daily practice, and opinions about screening for LJM as a complication of T2DM was conducted between December 2017 and February 2018
Summary
To the well-known micro- and macrovascular complications, type 2 diabetes mellitus (T2DM) is associated with musculoskeletal disorders of the upper extremities referred to as limited joint mobility (LJM), e.g. carpal tunnel syndrome (CTS) and adhesive capsulitis. The most commonly observed specific LJM disorders are trigger finger, Dupuytren’s contracture, carpal tunnel syndrome (CTS) and Alabdali et al BMC Family Practice (2019) 20:98 adhesive capsulitis [13,14,15,16,17,18,19,20,21,22,23] The prevalence of these disorders is lower in unselected populations: for adhesive capsulitis, 2–5% compared to 5–30% in patients with DM; for trigger finger, 1–2% compared to 5– 15%; Dupuytren’s contracture 13% vs 20–63%; and CTS 3.8% vs 25% [24,25,26,27,28]
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