Should Prognostic Indicators and Management Strategies for Adhesive Capsulitis Consider Diabetes Status? A Structured...

Adhesive capsulitis (AC) is a debilitating condition with a higher prevalence and severity in individuals with diabetes mellitus (DM). Despite known associations, the impact of DM on AC prognosis and treatment responses remains underexplored. This structured narrative review synthesises current evidence using a structured search and selection approach to determine whether diabetes status impacts the course and treatment response of AC, and whether it should be considered when planning management strategies.

The current review conducted a structured literature review across four electronic databases (PubMed, Google Scholar, CINAHL, and Medline) using a specific search strategy. In total, 996 articles were screened using the PICO format; full-text screening was based on pre-set inclusion and exclusion criteria and included 10 studies in the review. Data were extracted, and a narrative synthesis was performed.

The current review included 10 studies (5 retrospective, 5 prospective) with a total of 1128 participants from various countries. The mean age of participants ranged from 47 to 57 years. DM patients had higher baseline pain, restricted ROM, and poorer function. Six studies reported lesser improvements in DM groups for pain (p < 0.05), ROM (reduced flexion/external rotation, p < 0.01), and function (p < 0.05), across various validated scales. DM was identified as an independent prognostic factor using multivariable logistic regression analysis in three studies (odds ratios [ORs] 9.6-51.0). No study evaluated diabetes-specific management protocols.

DM status appears to be associated with a poorer prognosis in AC and may warrant consideration for inclusion in prognostic models and management strategies.