Joint contractures and scleroderma-like skin changes in the hands of insulin-dependent juvenile diabetics

We studied 34 unselected insulin-dependent juvenile diabetics by seeking contractures at the proximal interphalangeal (PIP) joints and scleroderma-like changes of the hands or elsewhere. We found 14 contractures of only the 5th PIP in 7 and of the PIP of other fingers as well in the others. Nine of these patients also had scleroderma-like skin changes. Only one of 34 age and sex matched healthy controls had a minimal contracture of the 5th PIP joint but had no skin changes. All patients found to have these abnormalities had had diabetes for 6 or more years and the difference in the disease duration between those with hand changes and those without was significant (p less than 0.01). There was no correlation of these changes with renal or ocular vascular changes in this small group of patients.