Complications musculo-squelettiques du membre supérieur au cours du diabète de type 1 : Ce que les diabétologues doivent savoir

Upper limb musculoskeletal complications affect most of the patients living with type 1 diabetes for more than 25 years. They can be very disabling and can even interfere with blood glucose monitoring or insulin injections. The pathogenesis of retractile diseases (frozen shoulder, Dupuytren's contracture) remains unclear. Their diagnosis is mainly clinical, the evolution often extends over a long period of time and recovery may be incomplete. Trigger fingers and De Quervain tenosynovitis frequently occur in patients with type 1 diabetes and are mostly treated by surgery with excellent results. Entrapment syndromes involving the median nerve (at carpal tunnel) or the ulnar nerve (at elbow and/or wrist) should be diagnosed and treated before irreversible nerve damage occurs. An EMG should be performed in order to determine the entrapment level and assess severity of the neural damage. With basic knowledge, the diabetologist should be able to refer those patients in due time to an orthopedic surgeon.