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Abstract

Objective: The prevalence of shoulder pathologies in diabetics is higher compared to non-diabetics. However, the exact reasons for this increased incidence remain unclear. This study aimed to assess shoulder pain and function in type two diabetes patients and explore their relationship with HbA1c levels and microvascular complications.
Methodology: Our prospective cross-sectional study involved 184 type two diabetic patients seen at the Family Medicine Diabetes Polyclinic of the Training and Research Hospital between July 18, 2022 to October 18, 2022. Patients provided sociodemographic data, diabetes duration, and were assessed using the UCLA Shoulder Score. Medical records supplied information on microvascular complications and recent HbA1c levels.
Results: Among the study cohort, 52.7% (n=97) were female. The median age was 59.5 years, with a median HbA1c level of 7.4% and a median diabetes duration of 14.5 years. Female participants demonstrated significantly lower UCLA Shoulder Scores compared to males, whereas higher educational attainment and income levels were positively associated with improved scores. Furthermore, there were significant inverse correlations between UCLA Shoulder Scores and diabetes duration, age, and body mass index. Patients presenting with diabetic retinopathy, nocturnal shoulder pain, or restricted shoulder mobility exhibited markedly reduced UCLA Shoulder Scores.
Conclusions: In this study, 34.2% of patients with Type-2 diabetes demonstrated poor shoulder function as measured by the UCLA Shoulder Score. The findings emphasize the importance of routine shoulder assessments in diabetic patients, particularly those with retinopathy, obesity, prolonged disease duration, female sex, or low socioeconomic status. Enhancing physician awareness of musculoskeletal complications in diabetes is essential. Future multicenter studies and a multisystemic approach incorporating musculoskeletal evaluation into diabetes management are recommended to improve understanding and care of shoulder pathologies in this population.