Table 1.
Characteristics of the selected studies.
| Title | Design | Sample | Outcome | Results |
|---|---|---|---|---|
| Abate et al. (2011) [26] |
Case control | Group 1: 30 subjects with NIDDM type Il and good glycemic control (age 73.9 ± 12.72) Group 2: 30 subjects without DM matched for age and gender (159 age 74.3 ± 4.24) group 3: 10 normal young subjects (age 26.3 ± 1.6) |
/a/ROM (goniometer) US evaluation SST |
ROM (ABD & FL) reduced in both group 1 and 2 vs. 3 (p < 0.001); ROM (ABD & FL) reduced in group 1 vs. 2 (p < 0.001). More US abnormalities in group 1 vs. 2. |
| Abate et al. (2010) [27] |
Case control | Group 1: 48 asymptomatic subjects with NIDDM type Il (age 71.5 ± 4.8) Group 2: 32 asymptomatic subjects, matched for age and sex, without NIDDM (age 70.7 ± 4.5) |
US evaluation SST, IST, SScT, BT and SAD | SST and BT thickness greater in DM group (p < 0.001). More frequent observed degeneration in rotator cuff and BT in DM group (p < 0.002). Increased rate of SST tears in DM group (p < 0.03). More effusions in SAD (p < 0.03) and tenosynovitis in BT (p < 0.001) in the DM group. Pathological findings prevalent in both groups, but not related with duration of DM |
| Balci et al. (1999) [28] |
Cross sectional | 297 subjects with DM type Il Group 1: 86 subjects DM type Il and adhesive capsulitis (age 59.23 ± 24 Group 2: 211 subjects DM type Il without adhesive capsulitis (age 53.6 ± 10.2) |
/p/ROM (goniometer): ABD, IR, Blood samples |
FS associated with reduced/p/ROM (p = 0.006), the age (p = 0.000), and duration of DM (p = 0.03). |
| Cole A et al. (2009) [8] |
Cross sectional | 3206 subjects (of which 682 with shoulder pain and/or stiffness; 221 with DM (age 20–95; median 45) |
ROM (inclinometer, visual): SPADI-questionnaire Blood samples |
DM patients (or elevated HbA1c levels) had higher prevalence of shoulder pain and/or stiffness (p = 0.02). |
| Czelusniak et al. (2012)) [29] | Cross sectional | 150 subjects with DM type Il (age 60.5 ± 12) |
UCLA-m rating scale Blood samples |
Pain present in 63,4% and dysfunction in 53.4%. No association between HbA1c and joint function, except for/a/FLROM and fasting blood glucose (p = 0.026) |
| Handa et al. (2003) [30] |
Case control | Group 1: 14 subjects with rotator cuff disease and DM type Il (age 56.8 ± 7.2 yrs) Group 2: 53 subjects with rotator cuff disease without DM (age 54.9 ± 8.5 yrs) |
Synovia specimens from subacromial bursa | Symptom duration not different between groups. Synovial proliferation more frequent in DM vs. non DM (p =0.0329) Shoulder joint contracture more frequent in DM vs. non DM (p = 0.0045) |
| Kang et al. (2010) [31] |
case control | Group 1: 80 subjects with DM type Il and chronicshoulder pain (age 62.6) Group 2: 339 controls without DM type Il and chronic shoulder pain (age 56.9) |
US evaluation rotator cuff | No difference in RC tearsor calcifying tendinopathy between DM vs non DM (p =ns) |
| Lee et al. (2015) [32] |
Cross sectional | 107 subjects with FS (age 46–68) | Diabetes status, Kcap /p/ROM (goniometer): FL, ABD, ER |
Kcap: DM = nDM (p = ns) Kcap was negatively correlated with/p/ROM (p < 0.005) |
| Mavrikakis et al. (1989) [33] | Case control | Group 1: 824 subjects with DM type Il (age 66.1 yrs) Group 2: 320 non DM controls matched for age and sex (age 65.7 yrs) |
X rays of the shouldersblood sample | Calcific shoulder periarthritis in DM> non DM (p < 0.001) Serum mean values: DM = non DM (p = ns) |
| Mavrikakis et al. (1991) [34] | Case control | Group 1: 900 subjects with DM type Il (age 36–93 yrs) Group 2: 350 non DM controls matched for age and sex (age 34–87 yrs) |
X rays of the shoulders blood sample | 3× more frequent calcific shoulder periarthritis in DM vs. non DM, associated with longstanding/poorly controlled DM, hypercholesterolemia, and hypertriglyceridemia. |
| Ramchurn et al. (2009) [35] | Cross sectional | Group 1: 96 subjects with DM (46 type I & 50 with type Il) Group 2: 100 controls |
HAQ health assessment questionnaire) Blood sample |
Shoulder capsulitis (25%), carpal tunnel syndrome (20%), tenosynovitis (29%), limited joint mobility (28%) and Dupuytrens contracture (13%) more prevalent in DM vs. non DM (p = 0.02); Mean HbA1c was higher in patients with combined shoulder and hand problems (9.1%) than in those with no upper limb problems (8.0%) (p = 0.018). No differences between type 1 and 2. |
| Salek et al. (2010) [36] |
Case control | Group 1: 30 subjects with DM type Il with FS Group 2: 30 matched type Il DM without frozen shoulder |
Blood sample | Fasting blood sugar (p = 0.012) and blood sugar 2 h after breakfast (p < 0.01), HbA1C (p < 0.05) and serum triglyceride levels (p < 0.001) were elevated in group 1 vs. group. |
| Schulte et al. (1993) [37] | Cross sectional | Group 1: 70 IDDM (age 38.4 yrs +/− 12.8) Group 2: 70 non DM matched controls (age 40.1 yrs +/− 13.3) | /p/ROM (goniometry): FL, EXT, ADD, ER, IR | In general, 6.1% lesser shoulder mobility in DM vs. non DM (p < 0.01) |
| Shah et al. (2015) [38] |
case control | Group 1: 26 subjects with DM type Il (age 64.5) Group 2: 26 matched non DM (age 64.2) |
SIF, ultrasound evaluation, /a/ROM (Flock of Birds), Shoulder FL strength (dynamometer), DASH. |
The mean SIF measure was higher in DM vs. non DM controls (p = 0.047). The BT and SST were 47% and 31% thicker (p < 0.001), respectively, in DM vs. non DM. Reduced shoulder elevation and ER in DM vs. non DM (p < 0.01). Shoulder FL strength was reduced by 27% (p = 0.004) in DM vs non DM. DM showed higher disabilities (DASH) than non DM (p < 0.01). |
| Shah et al. (2015) [39] |
Case control | Group 1: 26 subjects with DM type Il (age 64.5) Group 2: 26 matched non DM (age 64.2) |
/a/ROM (Flock of Birds), SPADI, DASH. | DM showed higher pain and disabilities (SPADI & DASH) vs. non DM (p < 0.01). Decreased shoulder EL and ER in DM vs. non DM (p < 0.05). No between groups difference in scapular upward rotation, or shoulder IR (p > 0.05) |
| Siu et al. (2013) [40] |
Case control | Group 1: 23 with DM; Group 2: 45 non DM. All subjects had with rotator cuff tearing based on MRI or sonographic findings. | Sum of ROM deficit score, Constant score, VAS score, subacromial synovial fluid collection | DM had increased subacromial IL-1β levels (p = 0.048), increased Sum of ROM deficit (p < 0.001) and increased VAS scores (p = 0.022) and lower Constant scores (p < 0.001) than non DM. |
Abbreviations: yrs = years; DM = diabetes mellitus; ID = insuline dependent; NID = non-insuline-dependent; ROM = range of motion; BT = biceps tendon; SST = supraspinatus tendon; SScT = Subscapularis tendon; IST = infraspinatus tendon; SAD = subacromial-subdeltoid bursa; SPADI = shoulder pain and disability index; DASH = Disabilities of the hand, arm and shoulder; VAS = Visual Analogue Scale; FL = flexion; EL = elevation; EXT = extension; ER = external rotation; IR =internal rotation; ABD = abduction; US = ultrasound; Kcap = capsular stiffness; ns = non-significant; SIF = skin intrinsic fluorescence; IL = interleukin.