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Quality of metabolic control, serum potassium, and aging are the major determinants of severity of musculoskeletal disorders in hospitalized diabetic patients

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Background

Diabetes is strongly associated with numerous musculoskeletal disorders (MSD) and may be considered as another group of diabetic complications.

Objective

We explored the association of diabetes type, duration, quality of metabolic control, applied therapy, and serum electrolytes, with prevalence and extent of musculoskeletal disorders as well as radiographic and EMG changes.

Methods

The case-control clinical study involved 80 patients with type 1 and 2 diabetes hospitalized at General Hospital Berane and Clinical Center Podgorica, Montenegro, in 2013. More than half of the diabetics had MSD. Peripheral nerve disorders were diagnosed by EMG. The musculoskeletal disorders were evaluated using the translated Short Musculoskeletal Function Assessment (SMFA) questionnaire. The statistical methodology involved T-testing, χ2 test, Spearman’s multiple correlation, and ordinal logistic regression.

Results

The incidence and the severity of MSD were significantly related to patients age, duration of diabetes, quality of metabolic control, serum potassium, radiographic, and EMG findings. However, in the regression analysis, only aging, mean blood glucose levels, and serum potassium were associated with the significant risk for development of MSD.

Conclusion

Advanced age, metabolic control, and hypokalemia are the main determinants of both prevalence and extent of musculoskeletal disorders in diabetics. Along with the strict glycemic control, an additional effort should be taken to avoid potassium depletion associated with diabetic ketoacidosis and to maintain optimal potassium homeostasis in diabetic patients receiving insulin, diuretics, or suffer gastrointestinal motility disorders.

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Data availability

The research data and materials available at: https://1drv.ms/x/s!AnToNOskCFMggehCKd16jy4nmNTj6g

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Authors and Affiliations

  1. Medical Faculty, University of Pristina, K.Mitrovica, Bul.A.Carnojevica 179, 10, Belgrade, 11070, Serbia

    Jovanovic N. Aleksandar, Ljiljana Smilic, Tanja Smilic, Snezana R. Markovic-Jovanovic, Javorka Mitic, Jelena Filimonovic & Nebojsa Matejic

  2. Clinical Centre Pristina, Gracanica, Serbia

    Radica D. Ristic

  3. Clinical Centre K.Mitrovica, Kosovska Mitrovica, Serbia

    Valdet Adzic & Bojan S. Jaksic

Authors
  1. Jovanovic N. Aleksandar
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  2. Ljiljana Smilic
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  3. Tanja Smilic
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  4. Snezana R. Markovic-Jovanovic
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  5. Javorka Mitic
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  6. Jelena Filimonovic
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  7. Radica D. Ristic
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  8. Valdet Adzic
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  9. Nebojsa Matejic
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  10. Bojan S. Jaksic
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Contributions

ANJ and SMJ composed the manuscript and wrote it including the tables.

JM and AJ identified the patients, took the medical history data, and filled in the forms.

LJS and BSJ performed the rheumatologic and radiologic diagnostic.

TS and VA and performed the endocrinologic diagnostic.

RDR and NM did the statistical tests and interpretations.

Corresponding author

Correspondence to Jovanovic N. Aleksandar.

Ethics declarations

Ethical approval

The survey was conducted respecting ethical principles for human clinical trials by the Declaration of Helsinki of 1983 [8] The study was approved by Ethical Committee, Faculty of Medicine, University of Pristina/K.Mitrovica.

Informed consent

All patients gave their written consent to use data from the medical documentation gathered during their hospitalization period for the research purposes.

Conflict of interest

The authors declared that they have no conflict of interest.

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Aleksandar, J.N., Smilic, L., Smilic, T. et al. Quality of metabolic control, serum potassium, and aging are the major determinants of severity of musculoskeletal disorders in hospitalized diabetic patients. Int J Diabetes Dev Ctries 40, 296–302 (2020). https://doi.org/10.1007/s13410-019-00776-5

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  • DOI: https://doi.org/10.1007/s13410-019-00776-5

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