Rheumatic-musculoskeletal manifestations in type 2 diabetes mellitus patients in south India

Aim: To determine the prevalence of rheumatic musculoskeletal disorders (RMSD) in type 2 diabetes mellitus (T2DM) and study their risk factors. Methods: Diagnosed patients of T2DM attending the diabetic clinic in a premier teaching institution in south India were interviewed and requested to mark their RMS pain sites on a mannequin and intensity of pain on a visual analogue scale (VAS). A complete RMS examination was done and diagnoses were noted. These RMSDs were compared with those in age- and sex-matched, non-diabetic individuals from the general population. Association of RMSD with variables was determined using Chi-square test and multiple logistic regression models for risk factors were created using SPSS 17.0 software. Results: Prevalence of RMSD in 310 cases and controls was 42.58%; 95% CI: 37.08-48.08 and 31.61%; 95% CI: 26.43-36.79, respectively. RMS pain was marked by 194 individuals. Knee was the most common site of pain (33.4%). Prevalence of common RMSD was osteoarthritis knee (20.64%; 95% CI 16.14-25.16), frozen shoulder (16.45%; 95% CI: 12.32-20.58), diffuse idiopathic skeletal hyperostosis (14.52%; 95% CI: 10.6-18.44) and limited joint mobility (8.06%; 95% CI: 5.03-11.09). Age (P = 0.046), duration of T2DM (P < 0.001) and glycosylated hemoglobin (P < 0.001) were found to have significant associations with RMSD. In logistic regression analysis, duration (OR: 1.467; 95% CI: 1.210-1.779) and severity (OR: 1.354; 95% CI: 1.169-1.569) of T2DM were identified as the risk factors. Conclusion: Thorough RMS examination should be included as an integral part of care in T2DM patients.