title: Rheumatic-musculoskeletal manifestations in type 2 diabetes mellitus patients in south India.
abstract: OBJECTIVE
  To determine the prevalence of rheumatic musculoskeletal disorders (RMSD) in type 2 diabetes mellitus (T2DM) and study their risk factors.
  
  
  METHODS
  Diagnosed patients of T2DM attending the diabetic clinic in a premier teaching institution in south India were interviewed and requested to mark their RMS pain sites on a mannequin and intensity of pain on a visual analogue scale (VAS). A complete RMS examination was done and diagnoses were noted. These RMSDs were compared with those in age- and sex-matched, non-diabetic individuals from the general population. Association of RMSD with variables was determined using Chi-square test and multiple logistic regression models for risk factors were created using SPSS 17.0 software.
  
  
  RESULTS
  Prevalence of RMSD in 310 cases and controls was 42.58%; 95% CI: 37.08-48.08 and 31.61%; 95% CI: 26.43-36.79, respectively. RMS pain was marked by 194 individuals. Knee was the most common site of pain (33.4%). Prevalence of common RMSD was osteoarthritis knee (20.64%; 95% CI 16.14-25.16), frozen shoulder (16.45%; 95% CI: 12.32-20.58), diffuse idiopathic skeletal hyperostosis (14.52%; 95% CI: 10.6-18.44) and limited joint mobility (8.06%; 95% CI: 5.03-11.09). Age (P = 0.046), duration of T2DM (P < 0.001) and glycosylated hemoglobin (P < 0.001) were found to have significant associations with RMSD. In logistic regression analysis, duration (OR: 1.467; 95% CI: 1.210-1.779) and severity (OR: 1.354; 95% CI: 1.169-1.569) of T2DM were identified as the risk factors.
  
  
  CONCLUSIONS
  Thorough RMS examination should be included as an integral part of care in T2DM patients.
authors.affiliation: Department of Internal Medicine, Medical College Hospital, Trivandrum, Kerala, India. mathewaj@live.com
authors.forename: Ashish J
authors.initials: AJ
authors.lastname: Mathew
authors.forename: Jayakumar B
authors.initials: JB
authors.lastname: Nair
authors.forename: Saran S
authors.initials: SS
authors.lastname: Pillai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology