Predictive factors and clinical effects of diabetic hand: A prospective study with 1-year follow-up

J Plast Reconstr Aesthet Surg. 2022 May 2;S1748-6815(22)00288-1. doi: 10.1016/j.bjps.2022.04.085. Online ahead of print.

Abstract

Aims: Diabetes mellitus is considered an etiological factor for hand-related conditions that are grouped under the term "diabetic hand" (DH), which includes limited joint mobility, Dupuytren's contracture, carpal tunnel syndrome, and trigger finger. This study aimed to identify predictive factors and the clinical effects of DH development among patients with diabetes.

Patients and methods: Consecutive Japanese adults with diabetes were prospectively recruited at a single outpatient center. We assessed the presence of DH at baseline and at the 1-year follow-up, which was considered present if the patient exhibited one or more of the hand disorders at either examination.

Results: The 590 eligible subjects had a mean age of 57 years and included 155 patients (26%) with DH. Binary logistic regression analysis revealed that DH was significantly associated with older age, longer diabetes duration, and higher body mass index. Patients with DH had significantly lower hand function and quality of life (QOL) scores. We assessed 476 patients at the 1-year follow-up, including 96 patients (20%) who had DH at baseline. Although 25 of the 96 patients (26%) experienced resolution of DH without specific treatment, 83 of 380 patients (22%) without DH at baseline had developed new DH-related conditions. At the 1-year follow-up, the group with DH was significantly older than that without DH.

Conclusion: Older age and prolonged duration of diabetes predicted the development of DH. Patients who are not old and do not have a prolonged duration of diabetes may experience DH resolution without specific treatment.

Keywords: Diabetic hand; Hand function; Predictive factor; Quality of life.