Regular screening of upper-extremity impairments may benefit Type 1 diabetes patients

Previous studies have shown that upper extremity impairments such as carpal tunnel syndrome, flexor tenosynovitis (trigger finger), frozen shoulder, Dupuytren's disease, and limited joint mobility are common in diabetic patients. These patients disabling and painful limitations in daily life.

The study revealed that patients with type 1 diabetes were significantly more likely to experience trigger finger (OR, 5.0), frozen shoulder (OR, 3.5), Dupuytren contracture (OR, 4.3) and carpal tunnel syndrome (OR, 3.5) than controls. Diabetes duration, older age, body mass index, HbA1c, and female sex were associated with higher UEIs.

Sabina Wagner, Copenhagen University Hospital–Steno Diabetes Center Copenhagen, Herlev, Denmark, and colleagues aimed to identify the current and lifetime prevalence of upper-extremity impairments among patients with type 1 diabetes and explore factors associated with UEIs in a controlled nationwide study.

For this purpose, the researchers paired data on upper-extremity impairments and health behaviour with clinical factors and sociodemographics data from national registers. Participants were 2,245 individuals with type 1 diabetes, and 841 comprised the control group. Differences between groups were evaluated using multivariable logistic regression and binomial proportions.

The study led to the following findings:

• Compared with controls, individuals with type 1 diabetes were significantly more likely to experience frozen shoulder (odds ratio [OR] 3.5), trigger finger (OR 5.0), carpal tunnel syndrome (OR 3.5), and Dupuytren contracture (OR 4.3).
• They were also more likely to have several coexisting impairments than the control group.
• Diabetes duration was associated with all four impairments.

"Our findings showed that upper-extremity impairments are common, particularly among individuals with type 1 diabetes," the researchers wrote. Therefore, they suggest regular screening for upper-extremity impairments in patients with type 1 diabetes.

Reference:

Sabina Wagner, Kirsten Nørgaard, Ingrid Willaing, Kasper Olesen, Henrik U. Andersen; Upper-Extremity Impairments in Type 1 Diabetes: Results From a Controlled Nationwide Study. Diabetes Care 1 June 2023; 46 (6): 1204–1208. https://doi.org/10.2337/dc23-0063