An overlooked rheumatologic manifestation of diabetes: diabetic cheiroarthropathy

  • Neslihan GokcenEmail author
  • Seher Cetinkaya Altuntas
  • Ilke Coskun Benlidayi
  • Murat Sert
  • Ersin Nazlican
  • Tunay Sarpel
Original Article



The objectives of the study were to analyze the clinical characteristic of diabetic cheiroarthropathy (DCA) in patients with type 1 diabetes mellitus (DM), type 2 DM, and prediabetes and to evaluate the frequency of DCA among groups.


The cross-sectional study was conducted at the Division of Endocrinology and Metabolism outpatient clinic over a 14-month period. A total of 239 patients (160 female, 79 male), who had type 1 DM, type 2 DM, and prediabetes, were enrolled. The demographics, clinical variables, and laboratory outcomes were recorded. Diabetic cheiroarthropathy was defined according to physical examination. The functional disability of patients with DCA was assessed by the self-administered questionnaire (disabilities of the arm, shoulder and hand-DASH).


Diabetic cheiroarthropathy was determined in 35.1% of all patients. The frequency of DCA was higher in patients with prediabetes (x2 = 0.009, post hoc power = 0.794). According to the logistic regression analysis, prediabetes (OR = 4.52, 95% CI 2.16–9.47, p < 0.001), presence of polyneuropathy (OR = 3.82, 95% CI 1.61–9.07, p = 0.002), and fasting glucose level (OR = 1.01, 95% CI 1.00–1.01, p = 0.004) found as the most effective risk factors in determining DCA. DASH disability scores were significantly higher in prediabetic patients than that in type 2 DM group (p = 0.021).


High frequency of DCA and impaired hand function are observed in prediabetic patients. Musculoskeletal manifestations can emerge as an early sign of diabetic status. Also, people who suffer from hand involvement should be examined for diabetes along with rheumatologic diseases.


Diabetes mellitus Diabetic cheiroarthropathy Function Hand Prediabetes 



The authors wish to thank Ilker Unal for his valuable contributions on statistical analysis.

Compliance with ethical standards




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  1. 1.Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Faculty of MedicineCukurova UniversityAdanaTurkey
  2. 2.Department of Internal Medicine, Division of EndocrinologyCukurova University, Faculty of MedicineAdanaTurkey
  3. 3.Department of Physical Medicine and RehabilitationCukurova University, Faculty of MedicineAdanaTurkey
  4. 4.Department of Public HealthCukurova University Faculty of MedicineAdanaTurkey

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