Diabetic hand syndromes as a clinical and diagnostic tool for diabetes mellitus patients

Diabetes mellitus (DM) is a chronic disease characterized by hyperglycemia with various complications including diabetic hand syndrome (DHS); a condition characterized by association of distinct entities; limited joint mobility (LJM), Dupuytren's disease (DD), flexor tenosynovitis (FTS) and carpal tunnel syndrome (CTS) resulting in significant morbidity and mortality. The aim of this study was to evaluate the prevalence of these changes and their association to diabetes duration. We studied 142 type 2 and 45 type 1 DM patients and investigated the presence of these hand changes and peripheral neuropathy (PNP).The prevalence of LJM was 29.4%, DD was 17.6%, FTS was 10.7% and CTS 41.7% in all diabetics. The prevalence of CTS was more in type 2 DM (83.3%) as compared to type 1 DM (24.4%). Age and duration of diabetes were clearly related to these changes. A clear association between these changes and PNP was observed. The prevalence of CTS and hand changes was higher in type 2 diabetics. The association of DD and PNP suggests that common factors could contribute to their pathogenesis. Consequently, clinical examination for diabetic hand should not ignore it.