title: Is diabetes associated with shoulder pain or stiffness? Results from a population based study.
abstract: OBJECTIVE
  To assess the association of shoulder pain and/or stiffness and diabetes mellitus in a population based cohort.
  
  
  METHODS
  Participants were randomly recruited from the North West Adelaide Health Study, a longitudinal, population based study. In the second stage, 3128 participants were assessed for diabetes mellitus and shoulder complaints via questionnaires, the Shoulder Pain and Disability Index (SPADI), physical assessment, blood sampling for fasting plasma glucose, and HbA1c levels.
  
  
  RESULTS
  Overall, 682 (21.8%) participants experienced shoulder pain and/or stiffness and 221 participants (7.1%) fulfilled criteria for diabetes mellitus. Those with diabetes had a higher prevalence of shoulder pain and/or stiffness (27.9% vs 21.3%; p = 0.025), and poorer SPADI disability subscore (p = 0.01) and total SPADI score (p = 0.02). After controlling for age, sex, obesity, and current smoking, the prevalence of shoulder pain and/or stiffness did not differ significantly between those with diabetes and those without (OR 1.05, 95% CI 0.76-1.45), nor were there significant differences in the SPADI disability subscore (p = 0.39) or total SPADI score (p = 0.32) between the 2 groups. After adjustment for covariates, there was no association between higher levels of HbA1c and shoulder pain and/or stiffness (p > 0.8). Range of shoulder movement was significantly reduced in those with diabetes (p < 0.05).
  
  
  CONCLUSIONS
  There is a higher prevalence of shoulder pain and/or stiffness in people with diabetes mellitus. The differences observed between those with diabetes and those without can largely be explained by the confounding factors of age, sex, obesity, and current smoking.
authors.affiliation: Department of Rheumatology, The Queen Elizabeth Hospital, 28 Woodville St., Woodville, South Adelaide, South Australia 5006, Australia.
authors.forename: Antonia
authors.initials: A
authors.lastname: Cole
authors.forename: Tiffany K
authors.initials: TK
authors.lastname: Gill
authors.forename: E Michael
authors.initials: EM
authors.lastname: Shanahan
authors.forename: Patrick
authors.initials: P
authors.lastname: Phillips
authors.forename: Anne W
authors.initials: AW
authors.lastname: Taylor
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Hill
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D048909:Diabetes Complications / Q000453:epidemiology* / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D016059:Range of Motion, Articular / Q000502:physiology; D012307:Risk Factors; D012737:Sex Factors; D020069:Shoulder Pain / Q000453:epidemiology* / Q000503:physiopathology; D012907:Smoking / Q000453:epidemiology; D055815:Young Adult