Abstract
Purpose: Many diabetics have musculoskeletal (MSK) problems. The literature suggests that MSK problems may complicate diabetes care. In this study we begin to explore this relationship.Methods: This is a retrospective chart analysis of diabetic patients from 3 community clinics north of Boston. Demographic, HgbA1c, medications, visit frequency, referrals and practitioner type data were extracted and tabulated on an annualized basis. The analyzer used standard ANOVA and linear regression using JMP(SAS Cary, NC).Results: The chart review covering 2007-2010 had an n = 172. IDDM patients had more visits/year for MSK complaints than NIDDM patients (5.5 v 2.6, p = .06). The higher HgbA1c the more total MSK visits (p = .08). Diabetics with baseline MSK complaints had more MSK visits/yr (7.2 vs. 5.6, p = .06) than non-MSK diabetics, but A1C didn’t significantly differ (7.8 v 8.3, p = 0.4). Hispanic patients had more MSK total visits (7.9 v 5.6, p = .0002), fewer referrals (.56 v .71, p = .05) worse A1c (8.3 v 7.6, p = 0.01) than non-Hispanics.Patients were seen more frequently if provider was an NP (1.9 MD v 2.4 Res v 3.6 NP, p = 0.07), but A1C in NP group was worse (7.4 MD v 7.9 Res v 8.5 NP, p = 0.1). Conclusions: Musculoskeletal complaints influence the frequency of interactions of diabetics with the healthcare system. More frequent visits for MSK complaints may have a secondary benefit of improving diabetic control. Our study seems to indicate disparities in access and care quality for the Hispanic population and across provider type.
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