An overlooked rheumatologic manifestation of diabetes: diabetic cheiroarthropathy
- 60 Downloads
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.
KeywordsDiabetes mellitus Diabetic cheiroarthropathy Function Hand Prediabetes
The authors wish to thank Ilker Unal for his valuable contributions on statistical analysis.
Compliance with ethical standards
- 1.Larkin ME, Barnie A, Braffett BH, Cleary PA, Diminick L, Harth J, Gatcomb P, Golden E, Lipps J, Lorenzi G, Mahony C, Nathan DM, Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group (2014) Musculoskeletal complications in type 1 diabetes. Diabetes Care 37:1863–1869. https://doi.org/10.2337/dc13-2361 CrossRefGoogle Scholar
- 7.Serban AL, Udrea GF (2012) Rheumatic manifestations in diabetic patients. J Med Life 5:252–257Google Scholar
- 17.Andréasson K, Saxne T, Bergknut C, Hesselstrand R, Englund M (2014) Prevalence and incidence of systemic sclerosis in southern Sweden: population-based data with case ascertainment using the 1980 ARA criteria and the proposed ACR-EULAR classification criteria. Ann Rheum Dis 73:1788–1792. https://doi.org/10.1136/annrheumdis-2013-203618 CrossRefGoogle Scholar
- 20.Bhat TA, Dhar SA, Dar TA, Naikoo MA, Naqqash MA, Bhat A, Butt MF (2016) The musculoskeletal manifestations of type 2 diabetes mellitus in a Kashmiri population. Int J Health Sci (Qassim) 10:57–68Google Scholar
- 23.Teichert T, Hellwig A, Peßler A, Hellwig M, Vossoughi M, Sugiri D, Vierkötter A, Schulte T, Freund J, Roden M, Hoffmann B, Schikowski T, Luckhaus C, Krämer U, Henle T, Herder C (2015) Association between advanced glycation end products and impaired fasting glucose: results from the SALIA study. PLoS One 10:e0128293. https://doi.org/10.1371/journal.pone.0128293 CrossRefGoogle Scholar
- 24.Jiménez IU, Díaz-Díaz E, Castro JS, Ramos JP, León MC, Alvarado Ríos JA, Auriostigue Bautista JC, Correa-Rotter R, Aguilar Salinas CA, Larrea F (2017) Circulating concentrations of advanced glycation end products, its association with the development of diabetes mellitus. Arch Med Res 48:360–369. https://doi.org/10.1016/j.arcmed.2017.07.001 CrossRefGoogle Scholar
- 27.Singla R, Gupta Y, Kalra S (2015) Musculoskeletal effects of diabetes mellitus. J Pak Med Assoc 65(9):1024–1027Google Scholar