IDF21-0561 Prevalence of shoulder musculoskeletal pain and disability in individuals with Diabetes Mellitus – a preliminary study

Abstract

Background: In Chile, it is estimated that 9.8% of adult population have Diabetes Mellitus (DM). Beyond the most reported complications of DM, musculoskeletal disorders are commonly found, receiving relatively little attention from health professionals. The evidences shows that musculoskeletal injuries in individuals with DM may occur due to the hyperglycemia, generating an accumulation of the non-enzymatic advanced glycation end-products (AGEs), increasing collagen crosslinking, generating abnormal collagen deposit in tendons and ligaments, turning them thicker, rigid and weaker. The shoulder joint is frequently affected, presenting limited mobility and pain. Research in this area is scarce, perhaps because other complications have been considered more life threatening. However, musculoskeletal disorders can reduce physical mobility, representing a substantial burden on morbidity and quality of life. Aim: The purpose of this study is to estimate the prevalence of shoulder pain and the shoulder pain and disability index (SPADI) in individuals with type 2 DM from Talca city (Chile). Method: This study was approved by the ethical committee (218/2020). Adults with type 2 DM participated in the study. A survey was performed to identify the presence of shoulder pain. The SPADI questionnaire was applied to the symptomatic participants, to identify their pain and disability level, with scores varying from 0–100 (the higher the score, the greater the disability). Prevalence was calculated through percentage with the 95% CI. Chi-squared test was performed to obtain information regarding the association between presence of pain and sex. Results: A total of 75 DM type 2 individuals participated in this preliminary study (♀ = 39; ♂ = 36; 57.6 ± 9.9 years old). The prevalence of shoulder pain was 52%. Of those with shoulder pain, 25.3% were female and 26.7% male. From the total sample, the prevalence of shoulder pain in female was 48.7% and male 51.3%. However, no association was found between the presence of pain and sex (p=0.64). The SPADI questionnaire presented a pain dimension scored at 65.6% ± 21.2; and a disability dimension scored at 51.5% ± 25.1.Tabled 1DM type 2 subjectsPrevalence of shoulder pain % (95% CI)Total sample (n=75)52 (0.50-0.54)Female (n=39)48.7 (0.47-0.50)Male (n=36)51.3 (0.49-0.53) Open table in a new tab Discussion: High prevalence of shoulder pain was found in the study, contrasting with a similar study which found a prevalence of 25.7% of shoulder pain in DM Scottish subjects. Studies have found that prevalence of shoulder pain in general population varies from 6.9-26%, further highlighting the high prevalence in our study. Regarding sex prevalence, the presence of pain was not associated to sex, converging with the literature that shows no difference between sex in frozen shoulder patients with DM. For SPADI scores, results are similar to those observed in the literature in patients with DM, in which the SPADI pain score was 56.7% and SPADI disability 51%. With this study, we hope to elucidate the proportion of existing cases of shoulder pain in type 2 DM individuals in Chilean population. It will enable to analyze which factors are related to the presence of pain and dysfunction, guiding in the development of specific rehabilitation protocols.