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Original Article
DOI: https://doi.org/10.13107/jcorth.2026.v11.i01.834
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Frequency of Pre-Diabetes and Diabetes in Cases of Adhesive Capsulitis: A Cross-Sectional Study

Original Article | Volume 11 | Issue 1 | JCORTH Jan-Jun 2026 | Page 41-47 | Ikjot Singh [1], Rohit Sharma [1], Rajan Sharma [1], Avneet Sandhu [1]. DOI: https://doi.org/10.13107/jcorth.2026.v11.i01.834
Authors: Ikjot Singh [1], Rohit Sharma [1], Rajan Sharma [1], Avneet Sandhu [1]
[1] Department of Orthopaedics, Sri Guru Ram Das Institute of Medical Sciences and Research (SGRDIMSAR), Vallah, Amritsar – 143 001, Punjab, India
Address of Correspondence:
Dr. Ikjot Singh, Department of Orthopaedics, SGRDIMSAR Vallah, Amritsar – 143 001, Punjab, India E-mail: ikjothmm123@gmail.com
Article Received : 2025-12-12,
Article Accepted : 2026-03-14

Abstract

Background Adhesive capsulitis (frozen shoulder) is a chronic musculoskeletal disorder associated with significant functional disability. Increasing evidence links this condition with metabolic disorders, particularly diabetes mellitus and pre-diabetes. However, the frequency of dysglycaemia in patients presenting with adhesive capsulitis remains understudied in the North Indian population. This study aimed to determine the frequency of pre-diabetes and diabetes in patients with adhesive capsulitis and to evaluate shoulder range of motion in relation to glycaemic status.

Methods A hospital-based cross-sectional study was conducted at the Department of Orthopaedics, SGRD Hospital, Vallah, Amritsar, from July 2024 to December 2025. One hundred consecutive patients with adhesive capsulitis (non-traumatic shoulder stiffness, restriction in ≥2 planes, age >18 years) were enrolled after written informed consent. Glycosylated haemoglobin (HbA1c) was estimated using the D10-HPLC method and classified per American Diabetes Association 2023 criteria as normoglycaemic (4.5–5.6%), pre-diabetic (5.7–6.4%), or diabetic (≥6.5%). Shoulder range of motion (flexion, abduction, external rotation in abduction and adduction) was measured by goniometry. One-way ANOVA was applied; p<0.05 was considered statistically significant.

Results The 51–60-year age group was most affected (37%), with a mean age of 56.3 years. A marked female preponderance was noted (67% vs. 33%). HbA1c revealed 44% diabetic, 26% pre-diabetic, and 30% normoglycaemic patients, yielding a combined dysglycaemia prevalence of 70%. Only 37% had a known prior diagnosis of diabetes; the remaining dysglycaemic cases were newly detected. Most patients (49%) presented within 3–6 months of symptom onset. ANOVA showed no statistically significant differences in shoulder flexion (p=0.654), abduction (p=0.578), external rotation in abduction (p=0.340), or external rotation in adduction (p=0.340) across glycaemic categories.

Conclusions Seventy percent of patients with adhesive capsulitis demonstrated impaired glucose metabolism, with a substantial proportion being previously undiagnosed. Routine HbA1c screening is recommended for all patients presenting with frozen shoulder. Glycaemic status did not significantly influence the degree of shoulder motion restriction at presentation, suggesting hyperglycaemia contributes to disease initiation rather than modulating acute clinical severity.

Keywords: Adhesive capsulitis, frozen shoulder, diabetes mellitus; pre-diabetes, HbA1c, glycosylated haemoglobin, range of motion, dysglycaemia

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© 2026 Journal of Clinical Orthopaedics
How to Cite This Article: Singh I, Sharma R, Sharma R, Sandhu A. Frequency of Pre-Diabetes and Diabetes in Cases of Adhesive Capsulitis: A Cross-Sectional Study. Journal of Clinical Orthopaedics 2026 May, 11(05): 41-47.