نوع مقاله : مقاله پژوهشی
نویسندگان
دانشگاه علوم پزشکی تهران
چکیده
چکیده:
پیش زمینه: وجود ارتباط بین بیماری دیابت ملیتوس و مشکلات سیستم عضلانی استخوانی در بسیاری از مطالعات پیشین اثبات شده است.هدف اصلی ما مطالعه شیوع بالا بودن قند خون (دیابت یا پره دیابت) در بیماران با شکایت درد شانه بوده و هم چنین پاسخ به این سوال است که آیا اندازه گیری سطح قند خون در این بیماران منطقی است؟
روش: در یک دوره یک ساله ازابتدای بهمن ماه 1398 تا ابتدای بهمن ماه 1399 بیماران مراجعه کننده به درمانگاه تخصصی شانه با شکایت درد شانه وارد این مطالعه مقطعی شدند.بیماران واجد شرایط بعد از اخذ رضایت آگاهانه مورد بررسی قرار گرفتند. یک چک لیست واخد شامل: داده های دموگرافیک ، سطح گلوکز ناشتای خون، تشخیص بیماری و اندکس توده بدنی (BMI) بودند.
یافته ها: 564 بیمار واجد شرایط وارد مطالعه شدند. از این 564 بیمار 106 بیمار ( 18.8%) مبتلا به دیابت بودند، 146 بیمار (25.9%) در مرحله پره دیابتی قرار داشتند و مابقی 312 بیمار( 55.3%) قند خون طبیعی داشتند. درصد بالاتری از مردان در مقایسه با زنان قند خون بالا داشتند( 54 درصد در مقابل 33.9 درصد). ارتباط معنی داری بین سطح گلوکز خون وپاتولوژی ایجاد کننده درد وجود نداشت(P = 0.191). .
نتیجه گیری: شیوع بالاتر اختلال قند خون در بیماران با درد شانه لازمه مطالعات بیشتر در این زمینه و تعریف گسترده تری از فاکتورهای پیششگویی کننده دیابت دارد. این نکته به ویژه در کشور ما که غربالکری فند خون به صورت روتین انجام نمی شود حایز اهمیت است.
کلیدواژه‌ها
موضوعات
عنوان مقاله [English]
Evaluation of blood glucose level in patients with shoulder pain attending the shoulder clinic: a cross-sectional study
نویسندگان [English]
- Nima Bagheri
- Mohammad Reza Guity
- Amir Hossein Karim
- Farbod Ioosefi
- Seyed Hadi Kalantar
- Samane Mahmood Abadi
Tehran university of medical sciences
چکیده [English]
Object: Correlation between Diabetes Mellitus (DM) and musculoskeletal problem has been established in many of the past studies. There are reports of high prevalence (up to 63%) of upper extremity impairment in diabetic patients. The main aim was to conduct a study to determine the prevalence of diabetes and prediabetes in patients with shoulder complaints. It may help the treating physician in managing patients with shoulder problems.
Methods: During a period of six months from February 2018 to August 2018, patients who consulted shoulder clinic with complain of shoulder pain were included in this cross sectional study. Eligible patients were enrolled after informed consent was obtained. A uniform checklist was completed for every patient. The key components of the checklist were: demographic data, fasting blood glucose(FBS), diagnosis, body mass index( BMI).Diagnosis of diabetes and prediabetes was done by FBS level( FBS between 100 to 126 considered prediabetes and more than 126 as diabetes.
Results: 564 eligible patients were enrolled in the study. Of the 564 patients, 18.8% had DM, 25.9% had pre-diabetes, and 55.3% had normal fasting blood glucose. A higher proportion of men had abnormal fasting glucose compared to women (54% and 33.9% respectively). There was no significant difference in blood glucose levels in respect to different shoulder pathologies (P = 0.191).
Conclusion: This study shows that population with shoulder complaint have a higher prevalence of DM than the normal population. This high proportion of patients with impaired blood glucose levels and shoulder pain necessitates further research in this course and advancement towards risk factors of DM. It is more important in community areas where routine screening of diabetes is not performed.
کلیدواژه‌ها [English]
- Diabetes Mellitus
- Shoulder Pain
- Glucose screening
- Correlation study
- Smith L, Burnet S, McNeil J. Musculoskeletal manifestations of diabetes mellitus. British journal of sports medicine. 2003 Feb;37(1):30.
- Deshmukh DP, Akarte AG. Musculoskeletal manifestations in type 2 diabetes mellitus. International Journal of Research in Medical Sciences. 2017 Jan 23;5(2):398-402.
- Hoff OM, Midthjell K, Zwart JA, Hagen K. The association between diabetes mellitus, glucose, and chronic musculoskeletal complaints. Results from the Nord-Trøndelag Health Study. BMC musculoskeletal disorders. 2008 Dec 2;9(1):160.
- American Diabetes Association. Standards of medical care in diabetes - 2018. Diabetes Care. 2018 Jan; 41(suppl 1): S1-159.
- Shah KM, Clark BR, McGill JB, Mueller MJ. Upper extremity impairments, pain and disability in patients with diabetes mellitus. Physiotherapy. 2015 Jun 1;101(2):147-54.
- Viikari‐Juntura E, Shiri R, Solovieva S, Karppinen J, Leino‐Arjas P, Varonen H, Kalso E, Ukkola O. Risk factors of atherosclerosis and shoulder pain–is there an association? A systematic review. European journal of pain. 2008 May 1;12(4):412-26.
- Rechardt M, Shiri R, Karppinen J, Jula A, Heliövaara M, Viikari-Juntura E. Lifestyle and metabolic factors in relation to shoulder pain and rotator cuff tendinitis: a population-based study. BMC musculoskeletal disorders. 2010 Jul 20;11(1):165.
- World Health Organization. Screening for type 2 diabetes: report of a World Health Organization and International Diabetes Federation meeting.
- American Diabetes Association. Screening for type 2 diabetes. Diabetes care. 2004 Jan 1;27(suppl 1):s11-4
- 2013 clinical practice guideline of Canadian diabetic association (revised:2016)
- American Diabetes Association. Standards of Medical Care in Diabetes—2017: summary of revisions. Diabetes Care. 2017 Jan 1;40(Supplement 1):S4-5.
- Azimi-Nezhad M, Ghayour-Mobarhan MP, Parizadeh MR, Safarian M, Esmaeili H, Parizadeh SM, Khodaee G, Hosseini J, Abasalti Z, Hassankhani B, Ferns G. Prevalence of type 2 diabetes mellitus in Iran and its relationship with gender, urbanisation, education, marital status and occupation. Singapore medical journal. 2008 Jul 1;49(7):571.
- Esteghamati A, Gouya MM, Abbasi M, Delavari A, Alikhani S, Alaedini F, Safaie A, Forouzanfar M, Gregg EW. Prevalence of diabetes and impaired fasting glucose in the adult population of Iran. Diabetes care. 2008 Jan 1;31(1):96-8.
- Rashedi V, Asadi-Lari M, Delbari A, Fadayevatan R, Borhaninejad V, Foroughan M. Prevalence of diabetes type 2 in older adults: Findings from a large population-based survey in Tehran, Iran (Urban HEART-2). Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017 Mar 8.
- Safran O, El-Haj M, Leibowitz G, Beyth S, Furman Z, Milgrom C, Kandel L. Should Patients With Frozen Shoulder Be Screened for Diabetes Mellitus?. Orthopaedic Journal of Sports Medicine. 2017 Jul 10;5(7):2325967117716450.
- Hadaegh F, Bozorgmanesh MR, Ghasemi A, Harati H, Saadat N, Azizi F. High prevalence of undiagnosed diabetes and abnormal glucose tolerance in the Iranian urban population: Tehran Lipid and Glucose Study. BMC public health. 2008 May 24;8(1):176.
- Viikari‐Juntura E, Shiri R, Solovieva S, Karppinen J, Leino‐Arjas P, Varonen H, Kalso E, Ukkola O. Risk factors of atherosclerosis and shoulder pain–is there an association? A systematic review. European journal of pain. 2008 May;12(4):412-26.
- Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults: the Third National Health and Nutrition Examination Survey, 1988–1994. Diabetes care. 1998 Apr 1;21(4):518-24.
- Barengo NC, Tamayo DC, Tono T, Tuomilehto J. A Colombian diabetes risk score for detecting undiagnosed diabetes and impaired glucose regulation. Primary Care Diabetes. 2017 Feb 28;11(1):86-93.
- McCully SP, Kumar N, Lazarus MD, Karduna AR. Internal and external rotation of the shoulder: Effects of plane, end-range determination, and scapular motion. Journal of shoulder and elbow surgery. 2005 Dec 31;14(6):602-10.
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