• Niels Gunnar Juel, Jens Ivar Brox, Cathrine Brunborg, HolteKristine BechKBDepartment of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway., and Tore Julsrud Berg.
• Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway. Electronic address: n_gj@hotmail.com.
• Arch Phys Med Rehabil. 2017 Aug 1; 98 (8): 1551-1559.

ObjectivesTo compare the prevalence of shoulder disorders and self-reported shoulder disability in patients with long-term type 1 diabetes mellitus and diabetes-free subjects; and to explore the association between the long-term glycemic burden and shoulder disability in the diabetes group.DesignCross-sectional study of shoulder diagnoses with 30 years' historical data on glycemic burden in patients with diabetes.SettingDiabetics center and a university hospital.ParticipantsSubjects attending the Norwegian Diabetics Center in 2015 with type 1 diabetes since 1970 or earlier were eligible (N=136). One hundred and five patients were included, and 102 (50% women; mean age, 61.9y) completed the study together with 73 diabetes-free subjects (55% women; mean age, 62.5y).InterventionsNot applicable.Main Outcome MeasureShoulder diagnoses decided through clinical examination according to scientific diagnostic criteria.ResultsFrozen shoulder was diagnosed in 60 (59%) patients with diabetes and 0 diabetes-free subjects, with a lifetime prevalence of 76% in the diabetes group versus 14% in the diabetes-free subjects. Patients with diabetes had higher disability and higher mean QuickDASH scores (23.0±19.9) than diabetes-free subjects (8.9±12.0), with a mean difference of -14.2 (95% confidence interval, -19.3 to -9.0) points (P<.001). We found an association between chronic hyperglycemia and QuickDASH scores, with a 6.16-point increase in QuickDASH scores per unit increase in glycated hemoglobin A1c (HbA1c) (P=.014).ConclusionsThe point prevalence of frozen shoulder in patients with long-lasting type 1 diabetes was 59%, and the lifetime prevalence was 76%. The diabetes group had more shoulder disability than diabetes-free subjects. The historical HbA1c level was associated with increased shoulder disability.Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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