Adhesive capsulitis of the shoulder and diabetes: a meta-analysis of prevalence

Abstract

Background: adhesive capsulitis (AC) results in progressive painful restriction in range of movement and can reduce function and quality of life. Whilst it has been associated with diabetes mellitus (DM), there is considerable variation in the reported prevalence of AC in the diabetic population. The aim of this study is to determine through meta-analysis the prevalence of AC in DM and examine whether it is influenced by type of DM or insulin therapy. We also aim to further establish the prevalence of DM in patients presenting with AC.

Methods: we conducted a literature search for terms regarding AC and DM on Embase and Pubmed NCBI.

Results: of 5411 articles identified, 18 were selected. Meta-analysis showed that patients with DM were 5 (95% CI 3.2-7.7) times more likely than controls to have AC. The overall prevalence of AC in DM was estimated at 13.4% (95% CI 10.2-17.2%). Comparison of prevalence in patients on insulin vs other treatments showed no significant difference between the two. Meta-analysis estimated the prevalence of DM in AC at 30% (95% CI 24-37%).

Conclusion: to our knowledge this is the first meta-analysis to estimate the overall prevalence of diabetes in a population with AC. A high prevalence of AC exists in DM and equally a high prevalence of DM is present in AC. Screening for DM should be considered in patients presenting with AC.

Keywords: diabetes; frozen shoulder; idiopathic adhesive capsulitis; prevalence.

Figures

Figure 1

Literature search results (PRISMA flowchart 2009).

Figure 2

Meta-analysis of prevalence of AC in populations with DM. The ‘subgroup within study’ defines whether the study population was combined (T1DM and T2DM) or unspecified.

Figure 3

Funnel plot of prevalence of AC in populations with DM.

Figure 4

Meta-analysis of prevalence of AC in patients with T1DM and T2DM.

Figure 5

Meta-analysis of prevalence of AC in populations with IDDM and NIDDM.

Figure 6

Meta-analysis of prevalence of AC in patients with DM on insulin therapy versus oral hypoglycaemic agents.

Figure 7

Meta-analysis of prevalence of AC in patients with DM versus non-diabetic controls.

Figure 8

Meta-analysis of prevalence of DM in populations presenting with AC.

Figure 9

Funnel plot of prevalence of DM in populations presenting with AC.