CLINICAL COURSE OF OSTEOARTHRITIS IN COMBINATION WITH DIABETES MELLITUS
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i1.13727Keywords:
osteoarthritis, type 2 diabetes mellitus, insulin resistance, radiological stagesAbstract
SUMMARY. The aim – to study the features of the clinical course of osteoarthritis in combination with type 2 diabetes mellitus (DM).
Material and Methods. The following clinical groups of dynamic observation were selected: Group I – 58 patients with osteoarthritis, Group II – 38 patients with osteoarthritis in combination with diabetes mellitus, Group III – 25 practically healthy people. By age and gender, the comparison groups did not differ significantly, they were comparable. In order to assess the pain syndrome and the general condition of the patient, the Lequesne algofunctional index was used. Deformation of the joints was assessed by three types of changes: limitation of range of motion; axial deformation; violation of the contact of articular surfaces. All patients underwent X-ray examination of the affected joints to determine the X-ray stage of osteoarthritis. Insulin resistance was assessed using the homeostatic model method - HOMA (homeostasis model assessment).
Results. In the group of patients with osteoarthritis in combination with diabetes mellitus, the course of osteoarthritis is severe with limitation of the amplitude of movements in the joints, their deformation and significant deterioration of functional capacity, periodic long-term exacerbations, progression and generalization of processes in various joints, especially the predominance of damage to the knee and hip joints. The authors note that such a clinical course indicates the worst prognosis. Aggravation of the course and prognosis of osteoarthritis was more often registered in women. Due to the multisystemic lesions, the progression of insulin resistance, patients must be observed, consulted and treated by a rheumatologist, traumatologist and endocrinologist.
Conclusions. The course of osteoarthritis with type 2 DM changes the clinical picture, the intensity of the joint syndrome, contributes to greater destruction of cartilage and bones, is accompanied by severe damage to the hip joints and their combination with damage to the knee joints with stage II and a higher degree of functional failure of the joints, impaired mobility and daily activities, condition insulin resistance, duration and severity of concomitant diseases.
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