Hand and shoulder diagnoses are associated with substantial bodily pain compared to vascular complications and long-term glycaemic control in people with long-term type 1 diabetes.

Abstract Background People with type 1 diabetes are burdened by musculoskeletal hand and shoulder diagnoses and vascular late complications. We aimed to explore associations of musculoskeletal diagnoses, 30-year HbA1c and vascular complications with pain, fatigue, depression, and quality of life (QoL) in an increasing group of long-term survivors of type 1 diabetes. Methodology This exploratory, observational study included 104 participants with type 1 diabetes ≥ 45 years’ duration who completed questionnaires assessing pain (RAND-36 bodily pain), fatigue (Fatigue Questionnaire), depression (Patient Health Questionnaire), overall QoL (WHOQoL–BREF) and diabetes-specific QoL (Audit of Diabetes-Dependent QoL). We used linear regression to estimate associations between hand and shoulder diagnoses, 30-year HbA1c ≥ 64 mmol/mol (8%) and vascular complications with PROs. Results Compared to 30-year HbA1c and vascular complications, combined hand and shoulder diagnoses showed the strongest estimated association with bodily pain; [B (95% confidence interval)] [-17.4 (-32.8, -2.1)], followed by 30-year HbA1c ≥ 64 mmol/mol [10.9 (-21.9, 0.1)], microvascular complications alone [-11.3 (-24.8, 2.1)], and micro- and macrovascular complications combined [-5.9 (-21.9, 10.2)]. Vascular complications, particularly microvascular, were associated with worse overall QoL and diabetes-specific QoL. Conclusions Musculoskeletal hand and shoulder diagnoses show stronger associations with bodily pain than vascular complications, while vascular complications appear more important for QoL in this cohort of long-term survivors with type 1 diabetes. Estimates where however uncertain due to limited sample size.