Prevalence of Adhesive Capsulitis in Patient with Type II Diabetes Mellitus and Its Impact on Shoulder Function

Abstract

Background: Type 2 diabetes mellitus is associated with musculoskeletal complications that may impair upper-limb function, including frozen shoulder characterized by painful restriction of glenohumeral motion and activity limitation. Objective: To determine the prevalence of frozen shoulder among adults with type 2 diabetes and to assess the association between glycemic-control category and shoulder function using the Shoulder Pain and Disability Index (SPADI). Methods: A cross-sectional observational study enrolled 138 adults with type 2 diabetes (HbA1c ≥6.5%) from diabetic care settings in Lahore. Frozen shoulder was identified clinically by capsular-pattern restriction of shoulder range of motion without traumatic history. Shoulder function was assessed using SPADI and categorized into normal, mild, moderate, severe, and very severe disability. Associations between glycemic-control categories (mild, moderate, severe uncontrolled) and SPADI disability strata, and between glycemic category and pain severity, were tested using chi-square. Results: Frozen shoulder was present in 39/138 participants, yielding a prevalence of 28.3% (95% CI 21.4%–36.3%). Mean SPADI score was 39.94±24.64 (range 9–121). Glycemic-control category was significantly associated with SPADI disability severity (p=0.0055; Cramer’s V=0.280), with Severe/Very severe disability increasing from 10.0% in mild uncontrolled to 42.1% in severe uncontrolled diabetes. Pain severity was not significantly associated with glycemic category (p=0.1652). Conclusion: Frozen shoulder was common in adults with type 2 diabetes and poorer glycemic category was associated with higher disability burden, supporting routine screening for functional limitation in diabetic care