Increased prevalence of soft tissue hand lesions in type 1 and type 2 diabetes mellitus: various entities and associated significance

Abstract

Sixty Type 1 (insulin dependent) and sixty Type 2 (non insulin dependent) diabetic patients attending a diabetology unit were examined in search of limited joint mobility, Dupuytren's disease, flexor tenosynovitis and carpal tunnel syndrome, in comparison with two populations of 60 non diabetic controls matched for sex and age with the Type 1 and the Type 2 diabetic patients. Microangiopathic and neuropathic complications, glycaemic control, blood pressure and tobacco consumption were simultaneously assessed in 39 of the 60 type 1 and in all the type 2 diabetic patients. The prevalence of the various soft tissue hand lesions was higher in both diabetic populations (respectively Type 1 and Type 2) than in their control populations: Limited joint mobility: 33.3 and 26.7% vs 5.0 and 8.3% (both p < 0.01); Dupuytren's disease: 35.0 and 30.0% vs 6.7 and 10.0% (both p < 0.01); flexor tenosynovitis: 23.3 and 16.7% vs 0.0 and 3.3% (p < 0.01 and p < 0.05); carpal tunnel syndrome: 26.7 and 15.0% vs 3.3 and 5% (p < 0.01 and NS). The prevalence of limited joint mobility in Type 1 diabetes was independently associated with increasing age (p < 0.05) and to lower extent with increasing duration of diabetes (p = 0.05), whereas the prevalence of Dupuytren's disease only correlated with increasing age in both types of diabetes (p < 0.05). In Type 2 diabetes, the prevalence of flexor tenosynovitis also increased independently with age (p < 0.05), and the prevalence of limited joint mobility increased in the opposite way to the body mass index after adjustment on age, duration of diabetes and sex (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)