Abstract

Disorders of musculo-skeletal (MSK) system are common conditions seen in diabetic patients. The present study investigated the pattern of MSK disorders among the Bangladeshi diabetic patients attending the Department of Physical Medicine and Rehabilitation of a tertiary care hospital in Dhaka over a period of one year. A total of 2062 diabetic patients with MSK disorders were included in the study. Degenerative joint diseases were more common (53.2%) than inflammatory arthropathies (20.1%).

Ibrahim Med. Coll. J. 2008; 2(2): 65-66

Key Words: Musculoskeletal (MSK) disorders, diabetic patients, BIRDEM

Address for Correspondence: Dr. Md. Shah Zaman Khan, Assistant Professor, Department of Physical Medicine and Rehabilitation, BIRDEM Hospital, 122 Kazi Nazrul Islam Avenue, Shahbagh, Dhaka-1000

Introduction

Diabetes is a multi-system disorder affecting 3 -7% of the adult population in different geographical areas.1,2 Diabetic patients may present with various MSK disorders. Adhesive capsulitis of shoulder joint is well established as a complication of diabetes.3,4 Trigger finger, catching and snapping of the fingers and complications involving joints e.g. Charcot’s arthropathy are frequent in diabetic patients.5,6 The aim of this study was to find out the pattern of MSK disorders among the Bangladeshi diabetic patients attending the Department of Physical Medicine and Rehabilitation of a tertiary care hospital in Dhaka.

Materials and Methods

Diabetic patients with complains of MSK disorders attending the Department of Physical Medicine and Rehabilitation of  Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM) between January – December 2005 were included  in the study.  Patients were categorized according to the criteria of American Rheumatology Association based on history, clinical examination and relevant investigations.

Results

A total of 2062 patients with MSK disorders were studied. Out of them 927 (44.9%) were males and 1135 (55.1%) were females. Out of 2062 patients, 31.9% were between the age group of 41-50 years and 29.8% was between 51 - 60 years.  Majority were house wives (56.5%) followed by retired servicemen (16.3%), service holders (13.8%), businessmen (7.4%) and teachers (2.3%). Rheumatoid arthritis was the commonest (20.1%) inflammatory arthropathy while lumber and cervical spondylosis constituted about 37% of all disorders. Details of the common MSK disorders are presented in Table-1.

Table-1: Common MSK disorders among diabetic patients (n=2062)

Discussion

In the present series as well as in other studies,  degenerative disorder of the locomotor system was found to be a common (50%)  condition.7-9 Back pain was the most frequent  MSK complain (32.9%) in our series which was similar to the findings of Bjella et al.8 Rheumatoid arthritis  was the commonest inflammatory arthropathy in the present series which was also reported by Alam et al.7   It may be concluded that degenerative disorders of the MSK system are more common than the inflammatory ones  amongst the diabetics.

References

1.  Report of a WHO consultation. Definition, diagnosis and classification of diabetes mellitus and its complications 1999; 2.

2.  Zimmet P. Diabetes - definitions and classification. Medicine International 1997; 39: 1-3.

3.  Arkkila PE, Kantolac M, Vikari JS et al. Shoulder copsulitis in type I and type II diabetic patients associated with diabetic complications and related diseases. Ann Rheum Dis 1996; 55: 907.

4.  Boyle- Walker KL, Gabard DL, Dietscl E, et al. A profile of patients with adhesive capsulitis. J Hand Ther 1997; 10: 222.

5.  Benedetti A, Noacco C, Simonutti M, Taboga C Diabetic trigger finger. N Engl J Med 1982; 306: 1552.

6.  Sergent S. Arthritis accompanying endocrine and metabolic disorders. In Kelley’s Text Book of Rheumatology. Shaun Ruddy, Edward D Harries, JR. Clemen B. Sledge eds. 6th ed. V2, WB Saunders company 2001; 1581-85.

7.  Alam MN, Haq SA, Moyeenuzzaman M et al. Rheumatological disorders in IPGMR. Bangladesh J Medicine 1996; 7: 1-7.

8.  Bjella Allender E, Magi M. Rheumatic disorders in Swedish population and health care system. J Rheumatol 1980; 7: 877-85.

9.  Sucur A. Evaluating the magnitude of socio-medical problem of rheumatic diseases in adult urban population. Acta Med Lugosl 1990; 44: 407-4.