Title: Prevalence of Cheiroarthropathy in Diabetic Patients in a Tertiary Care Centre – an Observational Study
Authors: Asmath Thasni.M, Sreedevi Menon Parappil, Mohan Raj Manjalavil, Chandni R
DOI: https://dx.doi.org/10.18535/jmscr/v7i3.12
Abstract
Introduction: Diabetic cheiroarthropathy (diabetic stiff hand syndrome) is a clinical condition characterized by thickened skin andpainless limitation of mobility of small joints of the hand. The objective of the study was to find out the prevalence of cheiroarthropathy in type 2 diabetes mellitus patients and to study its relationship with age, gender, duration of diabetes, glycaemic control and BMI.
Methods: A cross sectional study was conducted in 300 patients with type 2 DM. Diabetic cheiroarthropathy (diabetic stiff hand syndrome)or limited joint mobility was evaluated clinically by the ‘prayer sign’ in which the patients were asked to approximate the palmar surfaces of their interphalangeal joints, with the fingers fanned and the wrist maximally extended. If they were unable to do so, the test was considered positive. The data were statistically analysed.
Results: Cheiroarthropathy was seen in 21.7% of patients with type 2 diabetes. There was a statistically significant association betweenoccurrence of cheiroarthropathy and increasing age, duration of diabetes and poor glycaemic status.
Conclusion: Cheiroarthropathy is a commonly prevalent musculoskeletal disorder among patients with type 2 diabetes, its occurrencebeing more prevalent with increasing age, long duration of diabetes and poorly controlled glycaemic status.
Keywords: Type 2 diabetes mellitus, cheiroarthropathy, age, gender, duration of diabetes, glycaemic status, BMI
References
- Douloumpakas I, Pyrpasopoulou A, Triantaafyllou A, SampanisCh, Aslanidis S. Prevalence of musculoskeletal disorders in patients with type 2 diabetes mellitus: a pilot study. Hippokratia. 2007; 11:216-8.
- Tariq Ahmed Bhat: The Musculoskeletal Manifestations of Type 2 Diabetes Mellitus in a Kashmiri Population, International Journal of Health Sciences, 2016 Jan; 10(1): 57–68.
- Kapoor A., Sibbitt Jr. W.L.: Contractures in diabetes mellitus: The syndrome of limited joint mobility. Semin Arthritis Rheum 1989; 18:168.
- Sheetz M.J., King G.L.: Molecular understanding of hyperglycemia adverse effects for diabetic complications. JAMA 2002; 288:2579.
- Seibold J.R., Uitto J., Dorwart B.B., et al: Collagen synthesis and collagenase activity in dermal fibroblasts from patients with diabetes and digital sclerosis. J Lab Clin Med 1985; 105:664.
- Iwasaki T., Kohama T., Houjou S., et al: Diabetic scleroderma and scleroderma-like changes in a patient with maturity onset type diabetes of young people. Dermatology 1994; 188:228.
- Lawson P.M., Maneschi F., Kohner E.M.: The relationship of hand abnormalities to diabetes and diabetic retinopathy. Diabetes Care 1983; 6:140.
- Rosenbloom A.L., Silverstein J.H., Lezotte D.C., et al: Limited joint mobility in diabetes mellitus indicating increased risk for microvascular disease. NEngl J Med 1981; 305:191.
- Pandey A, Usman K, Reddy H, Gutch M, Jain N, Qidwai S. Prevalence of hand disorders in type 2 diabetes mellitus and its correlation with microvascular complications. Ann Med Health Sci Res. 2013;3:349–354
- Esther G Gerrits, Gijs W Landman, LeonieNijenhuis-Rosien, and Henk J Bilo: Limited joint mobility syndrome in diabetes mellitus: A minireview. World J Diabetes. 2015 Aug 10; 6(9): 1108–1112
- Ravindran Rajendran S, Bhansali A, Walia R, Dutta P, Bansal V, Shanmugasundar G. Prevalence and pattern of hand soft tissue changes in type 2 diabetes mellitus. Diabetes Metab. 2011;37:3127 p; 8(5): 507-510.
- Ray S, Datta AK, Sinhamahapatra P, Ray I, Mukhopadhyay P, Dasgupta S. Prevalence of rheumatic conditions in patients with diabetes mellitus in a tertiary care hospital. J Indian Med Assoc 2011;109:74-8.
- RP Agrawal1, Sunil Gothwal2, Prevalence of Rheumatological Manifestations in Diabetic Population from North West India; Journal of the association of physicians of india .september, 2014;vol 62
- Gamstedt A., Holm-Glad J., Ohlson C.G., et al: Hand abnormalities are strongly associated with the duration of diabetes mellitus. J Intern Med 1993; 234:189.
- Ramchurn N, Mashamba C, Leitch E, Arutchelvam V, Narayanan K, Weaver J, Hamilton J, Heycock C, Saravanan V, Kelly C. Upper limb musculoskeletal abnormalities and poor metabolic control in diabetes. Eur J Intern Med 2009;20:71821