The musculoskeletal complications seen in type II diabetics: predominance of hand involvement

The musculoskeletal complications of diabetes mellitus (DM), which are the most common endocrine arthropathy, have been generally ignored and poorly treated compared with other complications such as neuropathy, retinopathy and nephropathy. Like other quality of life issues, the musculoskeletal disability of DM has not been investigated effectively. The incidence of diabetic foot has decreased thanks to excellent foot care, but the hand is still an important target for diabetic complications. The aim of this study was to investigate early diabetic musculoskeletal complications on the basis of a collaborative multidisciplinary study design. For this purpose 78 patients (mean age 57.8 +/- 11.9 years, 55 women and 23 men) who had type II DM for 15 years maximally and 37 non-diabetic controls (mean age: 55.7 +/- 11.5, 27 women and 10 men) were randomly selected for inclusion in the study. All patients were evaluated by the Rheumatology, Orthopedic Rehabilitation and Hand Rehabilitation Divisions. Dupuytren's disease was present in 17 (21.8%) of 78 diabetic subjects as the most frequent and statistically significant complication of the musculoskeletal system. In correlation and logistic regression analysis, only retinopathy was significantly associated with duration of diabetes and diabetic foot. Long-term prospective randomised controlled trials on the effects of exercise in preventing musculoskeletal complications and disability in diabetics are needed.