Limited joint mobility in the hands and feet of adolescents with Type 1 diabetes mellitus

Chronic uncontrolled type 1 diabetes mellitus (type 1DM) is a very major risk for chronic systemic complications; specifically, the microvascular and macrovascular ones. Limited joint mobility (LJM) is a rare disease that complicates all types of diabetes and might indicate the high-risk odd for the diabetic patients to develop microvascular complications. We are reporting a 13-year-old female child with chronic uncontrolled type 1DM presenting with full blown clinical picture of bilateral hand LJM associated with significant growth failure yet has no clinical or biochemical evidence of microvascular complications. Literature research studies have emphasized the rarity of this manifestation in pediatric type 1 diabetic patients; however, it is an important clue and warning sign for microvascular complication occurrence in these patients.

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Severe Limited Joint Mobility Syndrome in a Child with Type 1 Diabetes Mellitus

The Indian Journal of Pediatrics ◽

10.1007/s12098-011-0622-7 ◽

2011 ◽

Vol 79 (7) ◽

pp. 959-960 ◽

Cited By ~ 1

Author(s):

Vandana Jain ◽

Richa Jain

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Joint Mobility ◽

Limited Joint Mobility ◽

Limited Joint Mobility Syndrome

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Shoulder Periarthritis and its Imaging Features in Patients with Type 1 Diabetes Mellitus

Annals of the National Academy of Medical Sciences (India) ◽

10.1055/s-0040-1712810 ◽

2017 ◽

Vol 53 (04) ◽

pp. 222-229

Author(s):

Abhilash Nair ◽

Devasenathipathy Kandasamy ◽

Raju Sharma ◽

HL Nag ◽

Upiderpal Singh ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Clinical Features ◽

External Rotation ◽

Adhesive Capsulitis ◽

Imaging Features ◽

Limited Information ◽

Limited Joint Mobility

ABSTRACT Aim: There is limited information on periarthritis/adhesive capsulitis of the shoulder (ACS) in patients with type-1-diabetes mellitus (T1D). We assessed the prevalence and characteristics of ACS in patients with type-1-diabetes mellitus. Methods: Consecutive 267 patients attending 'Diabetes of Young Clinic' were screened for ACS. Those with clinical features of ACS were further assessed by 'shoulder pain and disability index' (SPADI), radiograph and MRI of the shoulder. The average glycemic status (HbA1c) during preceding 2 years was assessed in patients with and without ACS. Controls were age and sex matched healthy subjects (1:1 ratio). Results: Sixteen of 267 patients (6.0%) with type-1-diabetes had clinical features of ACS, unlike none of the healthy controls (P < 0.001). Internal and external rotation of the shoulders was the most frequently restricted movements in ACS. Thickened coracohumeral ligament and axillary pouch obliteration was characteristic MRI feature, present in 80.0% in 73.3% cases, respectively. Though 14/16 type-1-diabetes patients with ACS were symptomatic, they never reported these complaints in diabetic clinic with the treating physicians. On regression analysis (odds ratio; 95% CI), duration of diabetes (1.1; 1.03-1.17, P < 0.01), retinopathy (3.6; 1.05-12.52, P = 0.04), and limited joint mobility (6.4; 1.88-21.95, P < 0.01) were independent predictors for presence of ACS in type-1-diabetes. The mean HbA1c and lipid levels were comparable in patients with or without ACS. Conclusions: Six percent of patients with type-1-diabetes had ACS, which can be detected on clinical screening and conﬁrmed by imaging to help initiate early treatment.

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Factors associated with mortality in Type 1 Diabetes Mellitus: A Case Report

Babcock University Medical Journal (BUMJ) ◽

10.38029/bumj.v3i1.36 ◽

2020 ◽

Vol 3 (1) ◽

pp. 45-48

Author(s):

Adesola Adekoya ◽

Musili Bolanle Fetuga ◽

Akolade Idowu ◽

Olufunmilola Abolurin

Keyword(s):

Diabetes Mellitus ◽

Developing Countries ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Glucose Monitoring ◽

Tertiary Hospital ◽

Adolescent Male ◽

Negative Effects ◽

Hands And Feet

Background: The management of children with type 1 diabetes mellitus (T1DM) remains a major challenge in developing countries. Case presentation: We report an adolescent male who was diagnosed with T1DM at the age of 11 years when he presented at a private hospital with diabetic ketoacidosis. He received emergency treatment there and was subsequently referred to our tertiary hospital for expert care. All through the management, there was poor clinic attendance, poor glucose monitoring, poor compliance with insulin therapy, and ultimately, poorly controlled diabetes. Later, he developed diabetic autonomic neuropathy which manifested as unawareness of bladder fullness with secondary enuresis and fecal incontinence. He was also severely malnourished. At his last admission, seven years after the initial diagnosis, he presented with burnt hands and feet, which were injuries sustained from putting his extremities in naked flames when he lapsed into a coma during a religious activity. He received multidisciplinary management but died a few weeks later. Discussion and conclusion: This case is being reported to draw attention to the plight of children with T1DM from the low socioeconomic class in developing countries. In such children, poverty and ignorance may have profound negative effects on the management and outcome of T1DM.

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