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dc.contributor.authorRamchurn, Navdha
dc.contributor.authorMashamba, Chiedza
dc.contributor.authorLeitch, Elizabeth
dc.contributor.authorArutchelvam, Vijayaraman
dc.contributor.authorNarayanan, Kilimangalam
dc.contributor.authorWeaver, Jola
dc.contributor.authorHamilton, Jennifer
dc.contributor.authorHeycock, Carol
dc.contributor.authorSaravanan, Vadivelu
dc.contributor.authorKelly, Clive
dc.date.accessioned2017-05-03T12:44:54Z
dc.date.available2017-05-03T12:44:54Z
dc.date.issued2009
dc.date.modified2014-07-21T05:08:36Z
dc.identifier.issn09536205
dc.identifier.doi10.1016/j.ejim.2009.08.001
dc.identifier.urihttp://hdl.handle.net/10072/61393
dc.description.abstractIntroduction An increased prevalence of musculoskeletal disease is recognised in diabetes and is a common source of disability. It is known to predominantly affect the upper limbs especially the hand and shoulder. The relationship with other complications of diabetes and glycaemic control is uncertain. We designed this study to clarify these relationships, and to assess differences between types 1 and 2 diabetes. Methods We identified a group of 96 people with established diabetes and examined them for the presence of locomotor disease focussing on the upper limbs. We recorded the mean HbA1c and the presence of diabetic complications, together with the health assessment questionnaire (HAQ) score. We explored correlations between locomotor disease and these variables using logistic regression. We compared data between type 1 and type 2 diabetics and contrasted the amalgamated data with that of a matched control population of medical out patients using Students t tests. Results Locomotor disease was present in 75% of diabetics with the upper limb the commonest site for abnormalities. This prevalence was significantly higher than that seen in the controls (53%) [p = 0.02]. Shoulder capsulitis (25%), carpal tunnel syndrome (20%), tenosynovitis (29%), limited joint mobility (28%) and Dupuytrens contracture (13%) were the most frequent findings and were much commoner than in controls. Capsulitis usually coexisted with other upper limb abnormalities and best predicted the presence of retinopathy and/or neuropathy. The mean HbA1c was significantly higher in patients with combined shoulder and hand problems (9.1%) than in those with no upper limb problems (8.0%) [p = 0.018]. The pattern of results was similar in type 1 and type 2 diabetes, although the prevalence of abnormalities and mean HAQ were significantly greater in type 2 patients, which may be in part a function of their greater mean age. Conclusion Upper limb locomotor abnormalities are very common in diabetes and are associated with worse glycaemic control and more diabetic complications. Assessment of upper limb locomotor disease in diabetes should include an estimate of glycaemic control and a search for other complications.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.languageEnglish
dc.language.isoeng
dc.publisherElsevier
dc.publisher.placeNetherlands
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom718
dc.relation.ispartofpageto721
dc.relation.ispartofissue7
dc.relation.ispartofjournalEuropean Journal of Internal Medicine
dc.relation.ispartofvolume20
dc.rights.retentionY
dc.subject.fieldofresearchClinical Sciences not elsewhere classified
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchcode110399
dc.subject.fieldofresearchcode1103
dc.titleUpper limb musculoskeletal abnormalities and poor metabolic control in diabetes
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.hasfulltextNo Full Text
gro.griffith.authorLeitch, Elizabeth M.


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