Prevalence of fibromyalgia syndrome in diabetics with chronic pain at the Kenyatta National Hospital

Abstract

Background: Fibromyalgia Syndrome (FMS), an increasingly recognized disorder with heightened response to pressure, characterized by Chronic Widespread Pain (CWP), for which no other cause can be identified. Diabetes Mellitus (DM) is the most common metabolic endocrinopathy. It is estimated that more than 50% of diabetic patients will suffer from chronic disability. Musculoskeletal complications of diabetes may be as a consequence of DM complications or direct associations e.g. FMS.
Objectives: To determine the prevalence of FMS in diabetics with chronic pain and to determine the severity of FMS related symptoms using the revised FMS questionnaire (FIQR) tool.
Design: Descriptive cross-sectional study.
Setting: The Diabetic Out-patient Clinic (DOPC), Kenyatta National Hospital (KNH).
Subjects: Two hundred and nineteen patients with chronic musculoskeletal pain.
Results: The prevalence of fibromyalgia in this group of patients was 61 (27.9%) (95% CI 21.9-34.2). Mean age for patients with FMS was 59.9 years, significantly older than patients without FMS (55.6%) (P=0.034). There was a higher female preponderance at 49 (80%). Majority of our study population were on followup for Type 2 DM (94.1%). The mean tender-point count for patients with FMS was estimated at 13.7 (SD 2.1). The mean FIQR score was 51.9 (SD 18.4) (moderate disease). Patients with FMS had a higher HBA1c value compared to those without (9.6% vs. 9.3%) (P=0.565). Other factors such as marital status, nature of employment, activities of daily living and type of medications used were not found to be statistically significant. (P˃0.05).
Conclusion: FMS is a prevalent disease in the diabetic population. There is increased need of awareness by the clinicians of this disease entity and a multidisciplinary approach required to manage patients presenting with CWP in DM.