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Very High Prevalence of Frozen Shoulder in Patients With Type 1 Diabetes of ≥45 Years' Duration: The Dialong Shoulder Study

2017; Elsevier BV; Volume: 98; Issue: 8 Linguagem: Inglês

10.1016/j.apmr.2017.01.020

1532-821X

Niels Gunnar Juel, Jens Ivar Brox, Cathrine Brunborg, Kristine Bech Holte, Tore Julsrud Berg,

Botulinum Toxin and Related Neurological Disorders

Objectives To compare the prevalence of shoulder disorders and self-reported shoulder disability in patients with long-term type 1 diabetes mellitus and diabetes-free subjects; and to explore the association between the long-term glycemic burden and shoulder disability in the diabetes group. Design Cross-sectional study of shoulder diagnoses with 30 years' historical data on glycemic burden in patients with diabetes. Setting Diabetics center and a university hospital. Participants Subjects attending the Norwegian Diabetics Center in 2015 with type 1 diabetes since 1970 or earlier were eligible (N=136). One hundred and five patients were included, and 102 (50% women; mean age, 61.9y) completed the study together with 73 diabetes-free subjects (55% women; mean age, 62.5y). Interventions Not applicable. Main Outcome Measure Shoulder diagnoses decided through clinical examination according to scientific diagnostic criteria. Results Frozen shoulder was diagnosed in 60 (59%) patients with diabetes and 0 diabetes-free subjects, with a lifetime prevalence of 76% in the diabetes group versus 14% in the diabetes-free subjects. Patients with diabetes had higher disability and higher mean QuickDASH scores (23.0±19.9) than diabetes-free subjects (8.9±12.0), with a mean difference of −14.2 (95% confidence interval, −19.3 to −9.0) points (P<.001). We found an association between chronic hyperglycemia and QuickDASH scores, with a 6.16-point increase in QuickDASH scores per unit increase in glycated hemoglobin A1c (HbA1c) (P=.014). Conclusions The point prevalence of frozen shoulder in patients with long-lasting type 1 diabetes was 59%, and the lifetime prevalence was 76%. The diabetes group had more shoulder disability than diabetes-free subjects. The historical HbA1c level was associated with increased shoulder disability.