Very High Prevalence of Frozen Shoulder in Patients with Type 1 Diabetes of More than 45 Years’ Duration. The Dialong Shoulder Study

Publication date: Available online 17 February 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Niels Gunnar Juel, Jens Ivar Brox, Cathrine Brunborg, Kristine Bech Holte, Tore Julsrud Berg
ObjectiveTo compare the prevalence of shoulder disorders and self-reported shoulder disability in patients with long-term type 1 diabetes mellitus and diabetes-free controls and explore the association between the long-term glycemic burden and shoulder disability in the diabetes group.DesignA cross-sectional study of shoulder diagnoses with 30 years' historical data on glycemic burden in the diabetes patients.SettingQuestionnaires, interviews and medical records were collected at the Norwegian Diabetics Center (NDC). A clinical examination and shoulder x-rays were performed at Oslo university hospital.ParticipantsIn 2015 136 patients attended NDC with type 1 diabetes since 1970 or earlier. All subjects were invited and 105 patients were included. 102 patients (50% women), mean age 61.9 years and 73 diabetes-free controls (55% women), mean age 62.5 years completed the study.InterventionsNot applicable.Main Outcome MeasuresShoulder diagnoses decided through clinical examination according to scientific diagnostic criteria.ResultsFrozen shoulder was diagnosed in 60 (59%) patients with diabetes and 0 controls with a lifetime prevalence of 76% in the diabetes group versus 14% in controls. Diabetes patients had higher disability, QuickDASH score (SD) 23.0 (19.9) than controls 8.9 (12.0), with a mean difference (95% CI) of -14.2 (–19.3 to -9.0) points, P < .001. We found an association between chronic hyperglycemia and QuickDASH score, with a 6.16 point increase in QuickDASH per unit increase in HbA1c, P = .014.ConclusionsThe 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 controls. The historical HbA1c level was associated with increased shoulder disability.



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