Insensitivity, Limited Joint Mobility, and Plantar Ulcers in Patients with Diabetes Mellitus

Musculoskeletal (MSK) conditions are more frequently found among patients with diabetes mellitus (DM) than in the non-diabetics. Despite several reports outside Africa, they have been under-studied among Africans. This study aimed to assess the overall prevalence and predictors of MSK conditions in Nigerian with types 2 diabetes mellitus (T2DM). A total of 268 adult with T2DM and 268 non-diabetic controls were recruited. All study subjects had their socio-demographics and clinical parameters obtained using interviewer-administered questionnaire. Musculoskeletal conditions among study subjects were classified using validated criteria and case definitions. Musculoskeletal disorders (MSKD) were significantly more frequent amongst subjects with DM (56% vs 22%, OR=4.5 p=0.001). Osteoarthritis (9.3% vs 4.1%, p=0.016), lumbosacral spondylosis (5.6% vs 2.2%, p=0.045), limited joint mobility (13.8% vs 5.6%, p-0.001), adhesive capsulitis (4.5% vs 1.5%, p-0.042) and rotator cuff tendinitis (3.7% vs 0.4%, p=0.006) were more frequent in DM subjects than in controls. Logistic regression showed that age (OR=2.1, CI=1.5-2.6) and waist circumference (OR=3.0, CI=2.6- 3.4) are independent predictors of MSKD among patients with diabetes. This study found higher prevalence of MSKD among diabetic subjects. It also identified certain factors associated with MSKD among patients with diabetes mellitus.

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LIMITED JOINT MOBILITY SYNDROME IN DIABETES MELLITUS

Rheumatology Science and Practice ◽

10.14412/1995-4484-2020-330-335 ◽

2020 ◽

Vol 58 (3) ◽

pp. 330-335

Author(s):

T. S. Panevin ◽

L. I. Alekseeva ◽

G. A. Melnichenko

Keyword(s):

Diabetes Mellitus ◽

Vascular Complications ◽

Pain Syndrome ◽

Pathological Process ◽

Late Complications ◽

Lower Limbs ◽

Joint Mobility ◽

Limited Joint Mobility ◽

Locomotor Apparatus ◽

Patients With Diabetes

Patients with diabetes mellitus (DM) often show changes in the locomotor apparatus (LMA), in particular cheiroarthropathy, a specific lesion of the connective tissue structures of the hand in the presence of persistent hyperglycemia, which leads to limited joint mobility (LJM) generally in the absence of pain syndrome. Some authors use the term «LJM syndrome» to describe LMA lesion in DM, since in the long course of the disease, the small and large joints of not only the upper, but also the lower limbs are involved in the pathological process. LJM is one of the little studied and poorly diagnosed conditions in comparison with traditional micro- and macro-vascular complications of DM, which, due to their direct correlation with life expectancy, receive more attention. The LJM syndrome is associated with other late complications of DM and can significantly impair functional activity, self-care, and quality of life. Damages to periarticular tissue and joints in DM are believed to be caused by the accumulation of glycation end products. A clinical examination plays a key role in the diagnosis of cheiroarthropathy.

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Foot Biomechanics in Patients with Diabetes Mellitus

Journal of the American Podiatric Medical Association ◽

10.7547/1010208 ◽

2011 ◽

Vol 101 (3) ◽

pp. 208-214 ◽

Cited By ~ 24

Author(s):

José Luis Lázaro-Martínez ◽

Francisco Javier Aragón-Sánchez ◽

Juan Vicente Beneit-Montesinos ◽

Maximo A. González-Jurado ◽

Esther García Morales ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Neuropathy ◽

Metatarsophalangeal Joint ◽

Foot Deformities ◽

Joint Mobility ◽

Limited Joint Mobility ◽

First Metatarsophalangeal Joint ◽

Foot Biomechanics ◽

Mobility Studies ◽

Patients With Diabetes

Background: We sought to identify the biomechanical characteristics of the feet of patients with diabetes mellitus and the interrelationship with diabetic neuropathy by determining the range of joint mobility and the presence and locations of calluses and foot deformities. Methods: This observational comparative study involved 281 patients with diabetes mellitus who underwent neurologic and vascular examinations. Joint mobility studies were performed, and deformities and hyperkeratosis locations were assessed. Results: No substantial differences were found between patients with and without neuropathy in joint mobility range. Neuropathy was seen as a risk factor only in the passive range of motion of the first metatarsophalangeal joint (mean ± SD: 57.2° ± 19.5° versus 50.3° ± 22.5°, P = .008). Mean ± SD ankle joint mobility values were similar in both groups (83.0° ± 5.2° versus 82.8° ± 9.3°, P = .826). Patients without neuropathy had a higher rate of foot deformities such as hallux abductus valgus and hammer toes. There was also a higher presence of calluses in patients without neuropathy (82.8% versus 72.6%; P = .039). Conclusions: Diabetic neuropathy was not related to limited joint mobility and the presence of calluses. Patients with neuropathy did not show a higher risk of any of the deformities examined. These findings suggest that the etiology of biomechanical alterations in diabetic people is complex and may involve several anatomically and pathologically predisposing factors. (J Am Podiatr Med Assoc 101(3): 208–214, 2011)

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