(Table 3).
Our study has some limitations. Firstly, we did not have a control
group. Secondly, a relatively small number of patients with type 1
diabetes were included in our study. However, musculoskeletal disorders
have been shown to occur more frequently in people with type 1 diabetes
when compared with the non-diabetic subject.24 Next,
we could not evaluate osteoarthritis and rheumatoid arthritis in this
study.
On the other hand, the prospective nature of the study, evaluation of
the patients by the same physician, and a relatively large number of the
study population could be designated as the strengths of the current
paper. Furthermore, our results have shed light on the pathogenesis of
musculoskeletal disorders by means of assessing the relationship between
metabolic parameters and microvascular complications.
Therefore, we suggest that further larger prospective studies with
control groups are required to understand the mechanisms and prevention
of these frequent but under-studied complications of type 1 and type 2
diabetes.
As a result of our study, 45.9% (n = 322) of the 702 diabetic patients
showed signs of musculoskeletal system disorders. The most common
disorders were carpal tunnel syndrome, Dupuytren’s contracture, and
adhesive capsulitis. Our study also draws attention to various risk
factors that are effective in musculoskeletal system involvement in
diabetes. These risk factors are age, duration of diabetes, HbA1c level
as a marker of glycemic control, and presence of microvascular
complications. A statistically significant relation was found between
the duration of diabetes and all musculoskeletal disorders except
Charcot arthropathy and between HbA1c level and Dupuytren’s contracture,
carpal tunnel syndrome, and adhesive capsulitis. In addition, the
frequency of musculoskeletal disorders increased with the presence of
microvascular complications.