Upper Limb Musculosketal Disorder in Type 2 Diabetes Mellitus: A Cross Sectional Study

Abstract

Introduction: Type 2 Diabetes mellitus (T2 DM) is common metabolic, chronic, multisystem disease involves joints, soft tissues and periarticular structures. The aim of our study was to investigate the type of upper limb musculoskeletal disorders (from shoulder to hand) in patients with type 2 diabetes mellitus.Materials and Method: Cross-sectional study at Department of Physical Medicine & Rehabilitation (PMR) in tertiary care setting.221 patients with T2DMaged between 35 to 70 years of age of either sex were included. Hand trauma, Physical labourer, Inflammatory arthritis, hypothyroidism, central or peripheral nervous system disease which includes cervical radiculopathy, and alcohol intake, were excluded from the study.Results: Out of 355 patients, 221 patients were selected and 134 patients were excluded. 58 patients of inflammatory arthritis, 23 cervical radiculopathy, 20 patient had disease duration of less than 2years, 15 had hypothyroidism, 7 was alcohol addicted, 6 labour worker, 4 had history of hand trauma and 1 had seizure. Out of 221 patients, 119 males and 102 females. Mean age was 52.45 years Mean duration of diabetes 8.9 yrs. ranged (1-24 years). The mean HbA1c was 7.3%. 42.6% of patients were overweight, 51.2% were obese & and 72.6% had hypertension. Shoulder involvement (48.86%) was the most common followed by hand (38.91%) followed by elbow in 12.16%). Adhesive capsulitis is the most frequent encountered problem found in about one third of patient, then Carpal Tunnel Syndrome in one seventh of cases, Loose Joint Mobility in one ninth& Flexor Tenosynovitis in one tenth of patient.Conclusion: Shoulder is involved in about half of the total upper limb involvement. Adhesive capsulitis is the most common manifestation of shoulder or overall upper limb musculoskeletal involvement. Carpal tunnel syndrome is the 2nd most common followed by limited joint mobility and flexor tenosynovitis.