Association of Diabetes Mellitus With the Risk of Developing Adhesive Capsulitis of the Shoulder: A Longitudinal Population-Based Followup Study


  • The conclusions herein do not necessarily represent those of the Department of Health, Executive Yuan, Republic of China.

Clinical Assistant Professor, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung Shan South Road, Taipei 100, Taiwan. E-mail:



Although it has been suggested that diabetes mellitus (DM) is a risk factor for developing adhesive capsulitis of the shoulder (ACS), data on the temporal association between these 2 conditions are sparse. The purpose of this population-based age- and sex-matched cohort study was to investigate the risk of developing ACS in patients with newly diagnosed DM.


A total of 78,827 subjects with at least 2 ambulatory care visits with a principal diagnosis of DM in 2001 were recruited for the DM group. The non-DM group comprised 236,481 age- and sex-matched randomly sampled subjects without DM. The 3-year cumulative risk of ACS was calculated using the Kaplan-Meier method. A Cox proportional hazards regression model was used to estimate the crude and adjusted hazard ratio (HR) of developing ACS.


During a 3-year followup period, 946 subjects (1.20%) in the DM group and 2,254 subjects (0.95%) in the non-DM group developed ACS. The crude HR of developing ACS for the DM group compared to the non-DM group was 1.333 (95% confidence interval [95% CI] 1.236–1.439, P < 0.0001), whereas the adjusted HR was 1.321 (95% CI 1.224–1.425, P < 0.0001) after adjustment for age, sex, and dyslipidemia.


This longitudinal population-based followup study showed that there is a significantly increased risk of developing ACS after developing DM.