Incidence of Diabetes Mellitus Type II and Pre-Diabetes among Shoulder Impingement Syndrome Patients and Related Modifying Factors: Epidemiological Study

Abstract

Objective: Measure the incidence of Diabetes Mellitus (DM) among patients with shoulder impingement syndrome and the factors that can modify that disease. Design: Prospective. Settings: Outpatient. Participants: 412 patients presented with unilateral or bilateral shoulder pain suspecting shoulder impingement neuromuscular diseases, or syndrome. Exclusion criteria: Those having manifestations suggesting of cervical radiculopathy, shoulder trauma history. Interventions: Each patient was subjected to the following; demographic data including occupation, body mass index, detailed medical history including DM history. Shoulder exam including impingement provocative tests; Hawkin test, Neer’s sign. Neck exam including Spurling test. Full neurological exam. Main outcome measures: Laboratory testing including glycosylated hemoglobin (HgA1c), liver and kidney functions. Shoulder MRI if possible. Results: Mean age 59.4 ± 11.123. All patients were right-handed, Male 37.1%, female 62.9%, Mean body mass index (BMI) 32.2 ± 8.2. Majority were manual workers (55.1%). No significant relationship between shoulder impingement sex but significant with BMI and age. HgA1c <5.5 has the fewest patients (7.3%), highest number of patients with HgA1c 5.5-6.0. significant incidence of shoulder impingement with rising category of HgA1c with highest among Hga1c >7 (p=0.0001) with significant bilateral disease. Significant incidence of shoulder impingement (unilateral or bilateral among diabetics (HgA1c >6) compared to non- diabetics (p=0.011). Conclusions: High incidence of DM /prediabetes among shoulder impingement patients. Level of HgA1c significantly proportionate to incidence and laterality. This suggests that it is part of musculoskeletal complication of DM. that can evidently occur with prediabetes status. Body mass index and age significantly affected the incidence but not the sex.