Gundtoft Per Hviid, Kristensen Anne Krogh, Gulaksen Birthe Anette, Brandslund Ivan, Vobbe Jette Wessel, Sørensen Lilli
Ortopædisk Afdeling, Kolding Sygehus, 6000 Kolding, Denmark.
Dan Med J. 2013 Oct;60(10):A4705.
Patients with diabetes mellitus have a high risk of developing symptoms from their shoulder. The generally accepted theory is that high blood glucose levels cause excessive glycosylation and that the delay in diagnosing diabetes mellitus may influence the risk of acquiring a musculoskeletal disorder. The aim of the study was to determine whether there was a large percentage of undiagnosed diabetes mellitus in a population of patients with shoulder symptoms.
The study population consisted of patients who were referred by their GP with shoulder symptoms. HbA1c level was measured, and height, weight, sex, age and diabetes status were registered. Patients with shoulder symptoms were compared to a group of patients who had been referred with knee symptoms and to the regional prevalence of unknown and diagnosed diabetes mellitus.
A total of 221 patients with shoulder symptoms were included. There was no significant difference in the prevalence of unknown diabetes mellitus between the group of patients with shoulder symptoms and the group of patients with knee symptoms or the regional prevalence. There was a significantly higher prevalence of diagnosed diabetes mellitus in the group of patients with shoulder symptoms.
The low prevalence of unknown diabetes mellitus we observed in this study may be owed to the fact that upper extremity disorder often occurs years after onset of diabetes, and for that reason patients have already been diagnosed when the extremity disorder is present. This study demonstrates a higher prevalence of diagnosed diabetes mellitus among patients with shoulder symptoms. It is important for physicians to be aware of this in the treatment of patients with shoulder symptoms.
糖尿病患者肩部出现症状的风险较高。普遍接受的理论是,高血糖水平会导致过度糖基化,而糖尿病诊断的延迟可能会影响患肌肉骨骼疾病的风险。本研究的目的是确定在有肩部症状的患者群体中,未被诊断出的糖尿病患者比例是否很高。
研究人群包括由全科医生转诊的有肩部症状的患者。测量糖化血红蛋白(HbA1c)水平,并记录身高、体重、性别、年龄和糖尿病状况。将有肩部症状的患者与一组有膝部症状的转诊患者以及当地未知和已诊断糖尿病的患病率进行比较。
共纳入221例有肩部症状的患者。有肩部症状的患者组与有膝部症状的患者组或当地患病率相比,未知糖尿病的患病率无显著差异。有肩部症状的患者组中已诊断糖尿病的患病率显著更高。
我们在本研究中观察到的未知糖尿病低患病率可能是由于上肢疾病通常在糖尿病发病数年之后出现,因此当出现上肢疾病时患者已经被诊断出来。本研究表明,有肩部症状的患者中已诊断糖尿病的患病率较高。医生在治疗有肩部症状的患者时了解这一点很重要。