The aim of this study was to evaluate the prevalence of fibromyalgia (FM) in patients with diabetes mellitus (DM).
The study included 100 consecutive unselected patients with DM attending our diabetes clinic. Patients were divided into two groups: 45 patients with type 1 diabetes and 55 patients with type 2 diabetes. A group of 50 healthy hospital staff members served as controls. The FM was diagnosed according to the 1990 American College of Rheumatology criteria. Counts of 18 tender points were performed by thumb palpation and assessed by dolorimeter. Routine biochemical tests and levels of HbA1c were recorded in each patient.
The main outcome measure was the association of FM with DM. Fibromyalgia was diagnosed in 17 patients (17%) with DM and in only one (2%) healthy control (P=0.008). No differences in patients were noted in the prevalence of FM between type 1 and type 2 diabetes (18.5% vs 15.5%, respectively). Patients with both FM and DM had significantly higher levels of HbA1c than DM patients without FM (9.2±1.1% vs 6.4±1.5%) (P<0.05). Similarly, the numbers of tender points, pain scores, and the prevalence of sleep disturbances, fatigue, and headaches were higher in this group of patients. A significant correlation was observed between the numbers of tender points and HbA1c levels in the DM patients with FM (r=0.72, P=0.027).
Fibromyalgia is a common finding in patients with types 1 and 2 diabetes, and its prevalence could be related to control of the disease. As with other diabetes complications, FM might be prevented by improved control of blood glucose levels.
This is a preview of subscription content,to check access.
Access this article
Goldenberg DL (1999) Fibromyalgia syndrome: a decade later. Arch Intern Med 159: 777–785
Wolfe F, Ross K, Anderson J, Russell IJ, Herbert L (1995) The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 38: 19–28
Wolfe F, Smythe HA, Yunus MB et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum 33: 160–172
Wolfe F, Cathey MA (1983) Prevalence of primary and secondary fibrositis. J Rheumatol 10: 965–968
Buskila D, Schnaider A, Neumann L, Zilberman D, Hilzenrat N, Sikuler E (1997) Fibromyalgia in hepatitis C virus infection. Arch Intern Med 157: 2497–2500
Dinerman H, Steere AC (1992) Lyme disease associated with fibromyalgia. Ann Intern Med 117: 281–285
Horowitz SH (1993) Diabetic neuropathy. Clin Orth Rel Res 296: 78–85
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (1999) Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 22 [Suppl 1]: S5–S19
Smythe H (1998) Examination of tenderness: learning to use 4 kg force. J Rheumatol 25: 149–151
Jacobssohn LTH, Nagi DK, Pillemer SR, Knowler WC, Hanson RL, Pettitt DJ et al (1996) Low prevalence of chronic widespread pain and shoulder disorders in Pima Indians. J Rheumatol 23: 907–909
Tishler M, Barak Y, Paran D, Yaron M (1997) Sleep disturbances, fibromyalgia and primary Sjögren's syndrome. Clin Exp Rheumatol 15: 71–74
Hudson JI, Goldenberg DL, Pope HG, Keck PE, Schlesinger L (1992) Comorbidity of fibromyalgia with medical and psychiatric disorders. Am J Med 92: 363–367
Forgacs S (1986) Diabetes mellitus and rheumatic disease. Clin Rheum Dis 12: 729–753
Renard E, Jaques D, Chammas M, Poirier JL, Benifacj C, Jaffiol C et al (1994) Increased prevalence of soft tissue hand lesions in type 1 and 2 diabetes mellitus: various entities and associated significance. Diabetes Metab 20: 513–521
The Diabetes Control and Complication Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long term complications in insulin dependent diabetes mellitus. N Engl J Med 329: 977–986
U.K. Prospective Diabetes Study Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk complications in patients with type-2 diabetes. Lancet 352: 837–853
About this article
Cite this article
Tishler, M., Smorodin, T., Vazina-Amit, M. et al. Fibromyalgia in diabetes mellitus. Rheumatol Int 23, 171–173 (2003). https://doi.org/10.1007/s00296-002-0279-7