Hand pathology in type 1 diabetes mellitus: a case-control study.

Area of Science:

• Endocrinology
• Diabetology
• Clinical Research

Background:

• Diabetic hand (DH) is a common complication in type 1 diabetes mellitus (T1D).
• Understanding the factors contributing to DH is crucial for effective management and prevention strategies.
• Previous research has explored various risk factors, but specific associations in T1D require further elucidation.

Purpose of the Study:

• To investigate the specific factors associated with the development of diabetic hand (DH) in patients diagnosed with type 1 diabetes mellitus (T1D).
• To utilize a matched case-control design to identify independent risk factors for DH in a T1D cohort.
• To analyze the relationship between glycemic control metrics, comorbidities, and DH incidence.

Main Methods:

• A retrospective case-control study was conducted involving 968 T1D patients, identifying 45 DH cases.
• Propensity score matching was employed to select 90 controls, balancing age, sex, diabetes duration, and retinopathy presence.
• Multivariable conditional logistic regression analyzed clinical data, comorbidities, and glycemic control (HbA1c, CGM metrics) to determine DH associations.

Main Results:

• The prevalence of diabetic hand (DH) in the T1D cohort was 4.6%.
• Significant associations with DH were identified for elevated HbA1c (OR 1.96) and increasing age (OR 1.06).
• Cardiovascular disease was more prevalent in DH cases but not an independent risk factor after adjustment; microvascular complications showed no significant differences.

Conclusions:

• Chronic hyperglycemia, reflected by higher HbA1c levels, is a significant driver of diabetic hand (DH) in type 1 diabetes mellitus (T1D).
• These findings highlight DH as a distinct complication of T1D, primarily linked to poor glycemic control rather than traditional vascular risk factors.
• Further investigation into the pathophysiological mechanisms and therapeutic interventions for DH is warranted.