Limited Joint Mobility in upper extremity in type 2 diabetes patients in general practice: A cross sectional study

Diabetes is common in the Netherlands, and also shoulder and hand disorders are
frequently seen in Dutch general practice. Despite the fact that several
international studies concluded that examination of the hand and shoulder
should be included in diabetic patients* periodic checks, screening for limited
joint mobility (LJM) is not incorporated in the guidelines. Given the
relationship between the duration of hyperglycaemia and LJM, the question
arises whether LJM is also prevalent in the Dutch diabetes population. If LJM
is prevalent, early diagnosis and treatment can reduce pain and functional
limitations, allowing for a better control of normal daily activities,
self-management and quality of life. Furthermore, the exact pathophysiology of
shoulder disorders in diabetes patients remains uncertain, but there is
evidence that the shoulder can be affected through two pathophysiological
pathways: connective tissue damage and neuropathy. New, in-depth knowledge is
needed in order to prevent the development of chronic shoulder pain.

The objectives of our study are
1) to estimate the prevalence of LJM in patients with diabetes type 2 in The
Netherlands, with a special focus on the shoulder.
2) to better understand the role of diabetic neuropathy in the development of
shoulder disorders.

Observational cross sectional study composed of two phases; the first phase is
descriptive and the second phase is analytic.

Filling in the questionnaire in phase 1 takes approximately 10-15 minutes. No
risks are associated.
In phase 2 the participants spend 30-60 minutes in the research centre (Meditta
Medical Centre); the participants undergo a physical examination and ultrasound
scanning of the shoulder. All these test are non-invasive and no risks are
known. Healthy participants will be examined at their department; this takes 15
minutes.