Upper limb musculoskeletal abnormalities in type 2 diabetic patients in low socioeconomic strata in Pakistan

This was an observational study in which type 2 diabetes patients attending our diabetic clinic were enrolled along with age and gender matched controls. Data was analyzed on SPSS 16.In total, 210 Type 2 diabetics (male 34.3%, female 65.7%) and 203 controls (male 35%, female 65%) were recruited. The mean age was 50.7± 10.2 years in diabetic group as compared to 49.5±10.6 years in the control group. The frequencies of hand region abnormalities were significantly higher in the diabetic subjects as compared to the controls (20.4%, p-value <0.001). Limited joint mobility (9.5% vs 2.5%), carpal tunnel syndrome (9% vs 2%), trigger finger (3.8% vs 0.5%), and dupuytren’s contracture (1% vs 0%) were found more frequent as compared to controls (all p-values <0.05). In the shoulder region of diabetic subjects, adhesive capsulitis and tendonitis was found in 10.9% and 9.5% respectively as compared to 2.5% and 2% in control group [p- value <0.001]. A weak but positive relationship was observed between age and duration of diabetes with these upper limb abnormalities. However, no correlation was found between the frequencies of these abnormalities with control of diabetes.A higher frequency of upper limb musculoskeletal abnormalities was observed in Type 2 diabetic patients as compared to control group.Diabetes mellitus (DM) is considered as an epidemic in the modern world and much of its morbidity and mortality is related to micro and macro vascular complications. However, it is also associated with musculoskeletal disorders of the hand and shoulder that can be very incapacitating and significantly compromise their quality of life [1,2].The manifestations of DM in the hand have been widely discussed in the last two decades, but the exact prevalence is still unknown. There is evidence that these entities are not only more frequent in patients with DM but may also be associated with its duration, poor metabolic control and presence of micro vascular complications [2-5]. Currently,