Prevalence and pattern of hand soft-tissue changes in type 2 diabetes mellitus

Aims and objectives. - Hand soft-tissue changes are well described in patients with T1DM, but not in T2DM patients. For this reason, this study aimed at examining the prevalence and pattern of hand soft-tissue changes in patients with T2DM. Methods. - A total of 206 consecutive patients with T2DM and 203 age-, gender- and occupation-matched healthy controls were examined by two individual observers, and then underwent the appropriate investigations. Results. - The 132 (64%) patients with T2DM included 187 hands compared with 96 (23.6%) healthy controls including 133 hands (P = 0.01 for both). Dupuytren's contracture (DC) (42 vs. 29.3%, respectively; P = 0.01), limited joint mobility (LJM) (39 vs. 28.5%, respectively; P = 0.01) and carpal tunnel syndrome (CTS) (5.3 vs. 1%, respectively; P = 0.01) were significantly higher in T2DM patients than in the controls, but not stenosing flexor tenosynovitis (FTS, 'trigger finger'). Indeed, none of the patients or controls had FTS. In patients with T2DM, DC showed a radial shift, and was more horizontal and severe than in the controls. These hand soft-tissue changes correlated significantly with age (P = 0.0001), duration of diabetes (P = 0.001) and the presence of microangiopathy (P = 0.001). Conclusion. - Hand changes are more prevalent and severe in patients with T2DM, and are correlated with age, duration of diabetes and microvascular complications. (C) 2010 Elsevier Masson SAS. All rights reserved.