Spectrum of musculoskeletal disorders in Nigerians with types 2 diabetes mellitus: prevalence and predictors

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.

A case study of frequent leech application in diabetes mellitus with special reference to frozen shoulder

In Frozen Shoulder (adhesive capsulitis), there is stiffness, pain and limited range of movements. It may happen after an injury, overuse of joint, from a disease such as diabetes or a stroke. Diabetes mellitus is a group of metabolic disorder with involvement of musculoskeletal system. In which most common is frozen shoulder. In frozen shoulder raise sugar in blood stick to collagen and restrict the movements. In first stage of frozen shoulder, Inflammation of capsule is present with severe pain. Various diseases like Shoulder Impingement, Frozen Shoulder, and Rotator cuff tendinitis have resembling symptoms under the umbrella of disease Avabahuka described in Ayurveda. In Avabahuka there is Vata-Kapha dushti still Leech application was carried out in first stage of Frozen Shoulder. Leech application is indicated in Pittaj Dushthi and Hirudine present in saliva of Leech helpful in platelet aggregation inhibitor. Hence increase in blood supply to shoulder region may arrest fibrosis of capsule. Aim- Study the efficacy of Leech application in Frozen Shoulder in Diabetes Mellitus. Objective- To study the efficacy of frequent Leech application in the management of pain and range of motion of shoulder joint in Diabetes Mellitus. Hypothesis- Leech application is effective in Frozen Shoulder caused by diabetes Mellitus.