Limited Joint Mobility, Dupuytren's Contracture and Retinopathy in Type 1 Diabetes: Association with Cigarette Smoking

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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Hand Abnormalities Associated with Non-Insulin-Dependent Diabetes Mellitus in Japan

Hand Surgery ◽

10.1142/s0218810497000197 ◽

1997 ◽

Vol 02 (02) ◽

pp. 117-122

Author(s):

Takuro Wada ◽

Yasuhiko Minagi ◽

Takashi Kirita ◽

Seiichi Ishii

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Dependent Diabetes Mellitus ◽

Diabetic Patients ◽

Dupuytren’S Contracture ◽

Joint Mobility ◽

Limited Joint Mobility ◽

Dupuytren's Contracture ◽

Tunnel Syndrome ◽

Flexor Tenosynovitis

We carried out a survey of hand abnormalities in 65 Japanese adult diabetics (non-insulin-dependent diabetes mellitus) and compared the result with that of 65 non-diabetic adults as controls. A significantly higher incidence of Dupuytren's contracture, limited joint mobility, carpal tunnel syndrome, and flexor tenosynovitis was found in the diabetic group. In the diabetic group, Dupuytren's contracture was noted in 10 patients (15%), limited joint mobility in 34 patients (52%), carpal tunnel syndrome in 21 patients (32%), and flexor tenosynovitis in 10 patients (15%). Dupuytren's contracture in the diabetic patients involved the fourth and fifth rays. In diabetic carpal tunnel syndrome, as compared to the idiopathic form, men were more frequently affected than women. Carpal tunnel syndrome showed a positive correlation with duration of the diabetes and use of insulin during the last twelve months prior to the examination. All of 10 diabetic patients with flexor tenosynovitis also had limited joint mobility. Six of these 10 patients also had carpal tunnel syndrome.

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Limited Joint Mobility Progression in Type 1 Diabetes: A 15-Year Follow-Up Study

International Journal of Endocrinology ◽

10.1155/2018/1897058 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Javier Labad ◽

Antoni Rozadilla ◽

Paula Garcia-Sancho ◽

Joan M. Nolla ◽

Eduard Montanya

Keyword(s):

Type 1 Diabetes ◽

Healthy Subjects ◽

Diabetic Patients ◽

Joint Mobility ◽

Limited Joint Mobility ◽

Patients With Diabetes ◽

Type 1 Diabetic Patients ◽

Baseline Examination

Objective. To assess the evolution of joint mobility over a period of 15 years in type 1 diabetic patients and healthy controls and to determine whether microalbuminuria is associated with a different evolution of joint mobility. Methods. Joint mobility of hand and wrist was determined in 63 patients with type 1 diabetes and 63 healthy subjects. Fifteen years later, 37 (58.7%) diabetic patients and 16 (25.4%) healthy subjects were studied again. Joint mobility was assessed with the Prayer sign and by measuring the angle of maximal flexion of the fifth and third metacarpophalangeal (MCP) joints and wrist. Patients with diabetes were visited 2–4 times every year with regular assessment of glycated hemoglobin (HbA1c), urinary albumin excretion (UAE), and ophthalmoscopy. Results. Fifteen years after the initial exam, diabetic patients showed reduced flexion of the fifth MCP joint (82.6 ± 5.8 versus 76.0 ± 6.4 degrees, p<0.001) and wrist (75.9 ± 8.1 versus 73.2 ± 7.4 degrees, p=0.015) compared to baseline examination. Joint mobility did not change significantly in healthy subjects. Patients with microalbuminuria showed greater reduction in hand joint mobility than diabetic patients with normal UAE or than healthy subjects (p<0.001). Conclusions. In type 1 diabetic patients, the severity of LJM progresses with time, and the progression is enhanced in patients with microalbuminuria.

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