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Diabetic Hand Complications in Prediabetes: A Controlled Observational Study
Kemal Erol1, Ezgi Akyıldız Tezcan2, Ulaş Serkan Topaloğlu3
1Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Selcuk University Medical Faculty, Konya, Turkey.
Insights
Prediabetes is linked to poorer hand function and more complications like limited joint mobility. Carpal tunnel syndrome and trigger finger significantly contribute to hand dysfunction in prediabetic individuals.
Area of Science:
- Endocrinology
- Rheumatology
- Musculoskeletal Health
Background:
- Prediabetes, a state of hyperglycemia, is a growing global health concern.
- Early detection of complications in prediabetes is crucial for timely intervention.
- Hand complications and functional deficits are increasingly recognized in metabolic disorders.
Purpose of the Study:
- To assess hand function and prevalence of diabetic hand complications in prediabetic individuals.
- To identify factors associated with hand dysfunction in prediabetes.
- To explore early musculoskeletal effects of prediabetes on the hands.
Main Methods:
- A controlled, observational study involving 100 prediabetic patients and 50 controls (aged 18-65).
- Hand function assessed using the Duruöz Hand Index (DHI); grip strength measured with a digital dynamometer.
- Prevalence of carpal tunnel syndrome (CTS), limited joint mobility (LJM), trigger finger (TF), and other hand conditions evaluated clinically.
Main Results:
- Prediabetic individuals exhibited significantly impaired hand function (higher DHI scores, P=.025).
- Limited joint mobility (LJM) was more prevalent in the prediabetic group (P=.024).
- Carpal tunnel syndrome (CTS), trigger finger (TF), and reduced grip strength were significantly associated with impaired hand function (P=.002, P=.007, P=.003, respectively).
Conclusions:
- Prediabetes is associated with reduced hand function and increased hand complications, notably LJM.
- Carpal tunnel syndrome (CTS) and trigger finger (TF) are strongly linked to hand dysfunction in prediabetes.
- Glycemic markers like HbA1c did not show a direct correlation with hand dysfunction in this cohort.
Objective:
The study aimed to evaluate diabetic hand complications and hand function in prediabetic individuals and explore factors influencing hand dysfunction and its early musculoskeletal effects in prediabetes.
Design:
Controlled, observational study.
Setting:
The study was conducted at a tertiary care hospital between January and July 2019.
Participants:
One hundred prediabetic patients and 50 normoglycemic controls aged 18-65 years were included. Participants were selected using a convenience sampling method, with eligibility based on American Diabetes Association prediabetes criteria. Participants with conditions affecting hand function were excluded.
Interventions:
Not applicable.
Main Outcome Measures:
Hand function was assessed using the Duruöz Hand Index (DHI). Grip strength measurements were obtained bilaterally using a calibrated digital dynamometer. The presence of hand complications such as carpal tunnel syndrome (CTS), limited joint mobility (LJM), trigger finger (TF), sclerodactyly, and Dupuytren's contracture was evaluated using standardized clinical criteria.
Results:
Prediabetic individuals had significantly higher DHI scores, indicating impaired hand function compared to controls (P=.025). Hand complications, particularly LJM (P=.024), were more prevalent in the prediabetic group. Regression analyses revealed that CTS (P=.002), TF (P=.007), and lower nondominant hand grip strength (P=.003) were each statistically associated with impaired hand function. No significant relationship was found between DHI scores and hemoglobin A1c (HbA1c), fasting glucose, or 2-hour post-oral glucose tolerance test glucose levels.
Conclusions:
Prediabetes is associated with impaired hand function and an increased prevalence of complications, particularly LJM. CTS and TF appear to have a strong statistical association with hand dysfunction in people with prediabetes, whereas HbA1c levels were not directly linked.
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