Quality of Life is Markedly Impaired by Rheumatological and Skin Manifestations in Patients with Type 1 Diabetes: A Questionnaire Survey

• Published in: Diabetes therapy Vol. 10; no. 2; pp. 635 - 647
• Main Authors: Nørgaard, Kirsten, Kielgast, Urd
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01-04-2019; Springer; Springer Nature B.V
• Subjects: Cardiology; Complications and side effects; Demographic aspects; Diabetes; Drug therapy; Endocrinology; Evaluation; Health aspects; Internal Medicine; Medicine; Medicine & Public Health; Mental depression; Original Research; Quality of life; Questionnaires; Rheumatic diseases; Risk factors; Skin diseases; Type 1 diabetes; Denmark; Depression; PAID; Non-acquired skin lesions; Rheumatological manifestations; Type 1 diabetes; Quality of life
• ISSN: 1869-6953; 1869-6961
• DOI: 10.1007/s13300-019-0587-5

Introduction
To estimate lifetime prevalence of diabetes-related upper limb and non-acquired skin manifestations in a representative type 1 diabetes (T1D) population and to identify associations between these conditions and quality of life.
Methods
A questionnaire on these complications and measures of quality of life (World Health Organization–Five Well-Being Index [WHO-5]), depression, and diabetes-specific burden (Problem Areas in Diabetes [PAID] scale) was sent to all T1D patients in a Danish clinic (
N
 = 583).
Results
The response rate was 68.6%. Lifetime prevalence of any upper limb soft tissue lesion was 72%; prevalence of any skin lesion was 10.5%. Frozen shoulder and vitiligo were most common upper limb and skin manifestation, at a prevalence of 53 and 9.1%, respectively. Compared to patients with no skin lesion, those with at least one skin lesion had more depression (19 vs. 33%;
P
 < 0.01) and lower WHO-5 scores. Frozen shoulder was associated with lower WHO-5 scores (
P
 < 0.001), more depression (29 vs. 14%; P < 0.001), and a higher PAID score (
P
 < 0.01). A diagnosis of carpal tunnel syndrome was associated with lower WHO-5 scores (
P
 < 0.001), a higher risk of depression (29 vs. 16%;
P
 < 0.01), and a higher PAID score (
P
 < 0.001).
Conclusion
Upper limb soft tissue lesions and diabetes-specific non-acquired skin lesions are very common in patients with T1D and strongly associated with impaired life quality and increased risk of depression.