Evaluation of musculoskeletal system findings and their relationship with microvascular complications in patients with Diabetes mellitus

Introduction and Objective: Diabetes mellitus is of great importance due to its complications. Since macrovascular and microvascular complications directly threaten survival, early recognition and treatment are prioritised. Musculoskeletal system findings associated with diabetes are also considered as chronic complications but are less recognised. Musculoskeletal findings cause deterioration in quality of life. In our study, we aimed to evaluate the relationship between musculoskeletal symptoms and vascular complications, diabetes duration, glycaemic control and metabolic parameters. Material and Method: Our study included 307 patients who were followed up with a diagnosis of DM between 2020 and 2024 in the Internal Medicine outpatient clinic of Süleyman Demirel University Faculty of Medicine Hospital. Patients under 18 years of age, pregnant, on dialysis, with rheumatological diseases and malignancies were not included in the study. Age, gender, duration of diabetes, BMI, vascular complications were recorded. Physical examination was performed for musculoskeletal system findings and radiological imaging was examined. Patients were divided into those with musculoskeletal involvement (Group 1) and those without (Group 2). 152 patients (49.5%) had musculoskeletal findings. SPSS Windows 22 programme was used for statistical analysis, p<0.05 was considered statistically significant. Results: Duration of diabetes and patient age were statistically significantly higher in Group 1. Microvascular and macrovascular complications were more common in Group 1. Osteoarthritis was the most common musculoskeletal finding. CTS and cheiroarthropathy were the second most common. Retinopathy was significantly associated with DISH, osteomyelitis. A significant association was found between nephropathy and cheiroarthropathy and peripheral neuropathy and osteomyelitis. Among the musculoskeletal findings, HbA1c values were found to be statistically significantly higher in trigger finger, DISH, osteomyelitis and Charcot arthropathy. The frequency of co-existence of other hand findings was found to be increased in patients with hand findings. Conclusion: Musculoskeletal system findings are more common in diabetic patients compared to the normal population. Musculoskeletal findings were found in approximately half of our patients. These findings are associated with patient age, duration of diabetes, poor glycaemic control and chronic complications of diabetes. Musculoskeletal complications should be recognised early because they cause morbidity and mortality. With good glycaemic control, both microvascular complications and musculoskeletal symptoms can be reduced. Although musculoskeletal system findings are common, they may be overlooked. For this reason, it is recommended that patients with diabetes should be questioned in terms of musculoskeletal system findings.