Prevalence of Musculoskeletal Manifestations and its Associated Factors in Patients with Type 2 Diabetes Mellitus in Ernakulam District: A Cross-Sectional Study.

Introduction: India is referred to as the "Diabetes Capital of the World" with a weighted prevalence of diabetes of 11.4%. In addition to microvascular and macrovascular complications, musculoskeletal manifestations of diabetes mellitus (MMDMs) also cause significant pain, morbidity, and a decrease in quality of life. Previous studies in our country were from tertiary healthcare centres, and the actual community-based prevalence of MMDMs is unknown. The study aims to determine the prevalence of MMDMs and the factors associated with them in the Ernakulam district of Kerala. Methods: A community-based cross-sectional study was done in 600 adults with diabetes in the Ernakulam district of Kerala. Cluster sampling was adopted. Through the probability proportional to sample size method, 20 clusters were identified with each having 30 participants. The study participants were clinically examined for various MMDMs. Results: The prevalence of MMDMs was found to be 44.83%. Osteoarthritis knee emerged as the most prevalent MMDM involving 22% of the participants, followed by frozen shoulder, in 12.2%. Diabetic cheiroarthropathy, trigger finger, and carpal tunnel syndrome were noted in 6.7%, 4.7%, and 3.8% of participants, respectively. Multivariable analysis showed a significant association between MMDMs and increased BMI, higher socioeconomic status, longer duration of diabetes, and unsatisfactory physical activity. Conclusion: This study highlights the need for regular musculoskeletal system assessment in patients with diabetes which needs to be made mandatory in clinical practice and also conducting screening for the same in the community level to prevent further complications and to improve quality of life.