Study of the prevalence of rheumatological manifestations in patients with type 2 diabetes mellitus in a tertiary care centre in north Kerala

Background: Unlike the vascular complications of diabetes mellitus(DM) which are life threatening, rheumatological manifestations lead to considerable morbidity and their treatment can result in significant improvement in the quality of life. Some of these have a close association with DM and may lead to the diagnosis of previously undiagnosed DM. This study aims to find out the prevalence of rheumatological manifestations in DM so that the commonly associated conditions can be looked for and early treatment ensured. Methods: A cross-sectional study was done over 1 year in patients with diabetes mellitus in a tertiary care centre in North Kerala. History and relevant details were collected using a questionnaire and physical examination was carried out to look for rheumatological manifestations. Investigations were done whenever necessary. Statistical analysis of the data was done. Results: This study included 219 patients with a mean age of 60.98 years. 139 patients (63.4%) were having some form of rheumatological manifestations. There was statistically significant association between duration of diabetes and the presence of conditions such as frozen shoulder, charcot’s joint, cheiroarthropathy, flexor tendinitis, dupuytren’s contracture and osteoarthritis. Conclusions: There is a definite increased prevalence of rheumatological manifestations in people with DM and the prevalence increases with duration of diabetes. There was statistically significant association between the rheumatological manifestations and the microvascular complications of DM. Osteoarthritis was the most prevalent manifestation but the older mean age of our study population may have acted as a confounding factor. Keypoints • There is increased prevalence of rheumatological manifestations in patients with type 2 diabetes mellitus • Prevalence increases with duration of diabetes • There was statistically significant association between duration of diabetes and the presence of conditions such as frozen shoulder, charcot’s joint, cheiroarthropathy, flexor tendinitis, dupuytren’s contracture and osteoarthritis. • There was statistically significant association for rheumatological manifestations like frozen shoulder, carpal tunnel syndrome, flexor tendinitis, charcot’s joint and osteoarthritis with the microvascular complications of diabetes.