Risk factors of limited joint mobility in type 1 diabetic adolescents: a two-center experience in Iraq

Authors

  • Wasnaa Hadi Abdullah Department of Pediatrics, Faculty of Medicine, Al-Mustansiriyah University, Baghdad, Iraq https://orcid.org/0000-0003-1549-3824
  • Rihab Faisal Alabedi Department of Pediatrics, Faculty of Medicine, University of Babylon, Hillah, Iraq https://orcid.org/0000-0003-3619-9018
  • Russul Feihan Mussa Department of Pediatrics, Faculty of Medicine, University of Babylon, Hillah, Iraq

DOI:

https://doi.org/10.13181/mji.oa.236382

Keywords:

diabetic nephropathy, diabetic retinopathy, joints, low-density lipoprotein, type 1 diabetes mellitus

Abstract

BACKGROUND Limited joint mobility (LJM) is the most common joint-related complications in patients with diabetes mellitus (DM) and indicates the presence of microvascular complications. This study aimed to assess the frequency of LJM among adolescents with type 1 DM (T1DM), its risk factors, and the other microangiopathies.

METHODS In this cross-sectional study, 75 patients (adolescents between 10 and 17 years old) with T1DM were assessed for hand joint mobility using a prayer sign test. It was carried out from January 15 to June 1, 2022 in Baghdad city, Iraq. The patients’ height, body mass index, blood pressure, glycated hemoglobin, and low-density lipoprotein (LDL) were recorded. Only 44 subjects were screened for diabetic nephropathy and 64 for diabetic retinopathy based on the eligibility criteria by the American Diabetes Association guidelines.

RESULTS Mean age was 13.60 (1.85) years, with a mean diabetes duration of 5.61 (2.87) years. LJM was found in 18 patients (24%). It was associated with a longer duration of diabetes (p<0.001), high LDL level (p = 0.012), diabetic nephropathy (p = 0.04), and diabetic retinopathy (p<0.001).

CONCLUSIONS The proportion of LJM was high among adolescents with T1DM, especially in those with a long duration of DM. It was associated with high LDL levels and diabetic microangiopathies (nephropathy and retinopathy).

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References

Somai P, Vogelgesang S. Limited joint mobility in diabetes mellitus: the clinical implications: the onset is insidious and may predate the recognition of overt disease. J Musculoskelet Med. 2011;28(4):118.

Al-Qahtani MH, AlQahtani FA. Limited joint mobility in a child with type 1 diabetes mellitus. Case Rep Med. 2021;2021:6397338. https://doi.org/10.1155/2021/6397338

Francia P, Anichini R, Seghieri G, De Bellis A, Gulisano M. History, prevalence and assessment of limited joint mobility, from stiff hand syndrome to diabetic foot ulcer prevention: a narrative review of the literature. Curr Diabetes Rev. 2018;14(5):411-26. https://doi.org/10.2174/1573399813666170816142731

Rosenbloom AL. Limited joint mobility in childhood diabetes: discovery, description, and decline. J Clin Endocrinol Metab. 2013;98(2):466-73. https://doi.org/10.1210/jc.2012-3776

Abate M, Schiavone C, Salini V, Andia I. Management of limited joint mobility in diabetic patients. Diabetes Metab Syndr Obes. 2013;6:197-207. https://doi.org/10.2147/DMSO.S33943

Cherqaoui R, McKenzie S, Nunlee-Bland G. Diabetic cheiroarthropathy: a case report and review of the literature. Case Rep Endocrinol. 2013;2013:257028. https://doi.org/10.1155/2013/257028

Garg SK, Chase HP, Marshall G, Jackson WE, Holmes D, Hoops S, et al. Limited joint mobility in subjects with insulin dependent diabetes mellitus: relationship with eye and kidney complications. Arch Dis Child. 1992;67(1):96-9. https://doi.org/10.1136/adc.67.1.96

Wang Y, Chen HJ. Use of percentiles and z-scores in anthropometry. In: Preedy VR, editor. Handbook of anthropometry: physical measures of human form in health and disease. London: Springer; 2012. p. 29-46. https://doi.org/10.1007/978-1-4419-1788-1_2

Barstow C, Rerucha C. Evaluation of short and tall stature in children. Am Fam Physician. 2015;92(1):43-50.

Centers for Disease Control and Prevention. About BMI for children and teens [Internet]. Centers for Disease Control and Prevention; 2022 [cited 2022 Jun 17]. Available from: https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html.

National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl 4th Report):555-76. https://doi.org/10.1542/peds.114.2.S2.555

Rosenbloom AL, Silverstein JH, Lezotte DC, Richardson K, McCallum M. Limited joint mobility in childhood diabetes mellitus indicates increased risk for microvascular disease. N Engl J Med. 1981;305(4):191-4. https://doi.org/10.1056/NEJM198107233050403

Chaudhuri KR, Davidson AR, Morris IM. Limited joint mobility and carpal tunnel syndrome in insulin-dependent diabetes. Br J Rheumatol. 1989;28(3):191-4. https://doi.org/10.1093/rheumatology/28.3.191

Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011;128 Suppl 5(Suppl 5):S213-56. https://doi.org/10.1542/peds.2009-2107C

American Diabetes Association. 13. Children and adolescents: standards of medical care in diabetes-2019. Diabetes Care. 2019;42(Suppl 1):S148-64. https://doi.org/10.2337/dc19-S013

Singh A, Satchell SC. Microalbuminuria: causes and implications. Pediatr Nephrol. 2011;26(11):1957-65. https://doi.org/10.1007/s00467-011-1777-1

Amer AE, Mahmoud MS, Abdelwahab TM, Abdulhamid HS, Elsayed A. Significant association between diabetic limited joint mobility and microvascular complication on type 1 diabetes. Al-Azhar Assiut Med J. 2013(Suppl 2);11(3):209-21.

Dyer BP, Rathod-Mistry T, Burton C, van der Windt D, Bucknall M. Diabetes as a risk factor for the onset of frozen shoulder: a systematic review and meta-analysis. BMJ Open. 2023;13(1):e062377. https://doi.org/10.1136/bmjopen-2022-062377

Choi JH, Kim HR, Song KH. Musculoskeletal complications in patients with diabetes mellitus. Korean J Intern Med. 2022;37(6):1099-110. https://doi.org/10.3904/kjim.2022.168

Gautieri A, Passini FS, Silván U, Guizar-Sicairos M, Carimati G, Volpi P, et al. Advanced glycation end-products: Mechanics of aged collagen from molecule to tissue. Matrix Biol. 2017;59:95-108. https://doi.org/10.1016/j.matbio.2016.09.001

Gerrits EG, Landman GW, Nijenhuis-Rosien L, Bilo HJ. Limited joint mobility syndrome in diabetes mellitus: a minireview. World J Diabetes. 2015;6(9):1108-12. https://doi.org/10.4239/wjd.v6.i9.1108

Clarke CF, Piesowicz AT, Spathis GS. Limited joint mobility in children and adolescents with insulin dependent diabetes mellitus. Ann Rheum Dis. 1990;49(4):236-7. https://doi.org/10.1136/ard.49.4.236

Traisman HS, Traisman ES, Marr TJ, Wise J. Joint contractures in patients with juvenile diabetes and their siblings. Diabetes Care. 1978;1(6):360-1. https://doi.org/10.2337/diacare.1.6.360

Arkkila PE, Kantola IM, Viikari JS. Limited joint mobility in type 1 diabetic patients: correlation to other diabetic complications. J Intern Med. 1994;236(2):215-23. https://doi.org/10.1111/j.1365-2796.1994.tb01286.x

Duffin AC, Donaghue KC, Potter M, McInnes A, Chan AK, King J, et al. Limited joint mobility in the hands and feet of adolescents with type 1 diabetes mellitus. Diabet Med. 1999;16(2):125-30. https://doi.org/10.1046/j.1464-5491.1999.00030.x

El Dayem SMA, El Bohy AEM, Battah AA. Sclerodactyly and diabetic complications among Egyptian adolescent type 1 diabetic patient. Open Access Maced J Med Sci. 2019;7(23):4004-9. https://doi.org/10.3889/oamjms.2019.641

Labad J, Rozadilla A, Garcia-Sancho P, Nolla JM, Montanya E. Limited joint mobility progression in type 1 diabetes: a 15-year follow-up study. Int J Endocrinol. 2018;2018:1897058. https://doi.org/10.1155/2018/1897058

Lo SF, Chu SW, Muo CH, Meng NH, Chou LW, Huang WC, et al. Diabetes mellitus and accompanying hyperlipidemia are independent risk factors for adhesive capsulitis: a nationwide population-based cohort study (version 2). Rheumatol Int. 2014;34(1):67-74. https://doi.org/10.1007/s00296-013-2847-4

Pandey A, Usman K, Reddy H, Gutch M, Jain N, Qidwai S. Prevalence of hand disorders in type 2 diabetes mellitus and its correlation with microvascular complications. Ann Med Health Sci Res. 2013;3(3):349-54. https://doi.org/10.4103/2141-9248.117942

Kowluru RA. Cross talks between oxidative stress, inflammation and epigenetics in diabetic retinopathy. Cells. 2023;12(2):300. https://doi.org/10.3390/cells12020300

Akpoveso OP, Ubah EE, Obasanmi G. Antioxidant phytochemicals as potential therapy for diabetic complications. Antioxidants (Basel). 2023;12(1):123. https://doi.org/10.3390/antiox12010123

Published

2023-03-20

How to Cite

1.
Abdullah WH, Alabedi RF, Mussa RF. Risk factors of limited joint mobility in type 1 diabetic adolescents: a two-center experience in Iraq. Med J Indones [Internet]. 2023Mar.20 [cited 2024Nov.21];31(4):239-44. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/6382

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Section

Clinical Research
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