Limited joint mobility in type 1 diabetic patients: correlation to other diabetic complications

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Abstract
Objectives. To examine the association between limited joint mobility (LJM) and complications of diabetes in adult patients with type 1 diabetes. Design. Cross-sectional study in diabetic patients and healthy controls. Setting. The study was performed at the department of medicine in Turku University Hospital (n = 103), a private diabetes outpatient clinic (n = 153) and the municipal health centre of Turku (n = 29), Finland. Subjects. We studied 285 diabetic patients [age (mean ± SD): 33.4 ± 10.0 years] and 288 healthy nondiabetic controls [age (mean ± SD): 32.3 ± 9.2]. Main outcome measures. The limitations of several joints were examined with a goniometer. The diabetic patients were assessed in terms of the following complications: background and proliferative retinopathy, peripheral symmetrical polyneuropathy, autonomic neuropathy, impotence as well as clinical and incipient nephropathy; serum lipid values were also measured. Results. The prevalences of LJM were 58% and 14% in diabetic patients and in healthy controls, respectively. The diabetic patients with LJM had a 2.8-fold risk of proliferative retinopathy [95% confidence interval (CI): 1.1–7.3] and a 3.6-fold risk of nephropathy (95% CI: 1.4–9.3) compared to patients without LJM, when the confounding effect of the duration of diabetes was excluded. LJM was not related to metabolic control of diabetes, microalbuminuria, autonomic neuropathy or impotence. The association between LJM and peripheral symmetrical polyneuropathy was exclusively explained by the duration of diabetes. The correlation between LJM and serum total and low-density lipoprotein cholesterol was dependent on the association between LJM and nephropathy. LJM did not relate to serum high-density lipoprotein cholesterol or triglyceride values. Conclusions. The diabetic patients with LJM had an increased risk of proliferative retinopathy and nephropathy compared to patients without LJM.