(Effect of Diabetes On The Hand (Diabetic Hand

Abstract

Diabetes mellitus (DM) is a wide spread chronic disease. Untreated diabetes can cause many complications The incidence of diabetes mellitus is 4.5% of all population with 20% of the diabetic patients having hand affection . The present study encompassed a total of fifty diabetic patients (one hundred hands). These patients were recruited from the diabetes outpatient clinic of Ain shams university hospitals. The mean age of diabetic patients was 53.12 ± 13.37 years. The mean duration of diabetes mellitus was 11.2 ± 9.97 years. The effects of diabetes mellitus on the hand include dermatological affection in the form of (thick skin, yellowish discoloration of the skin and Dupuytren’s contracture), muscloskeletal affection including (joint, muscular, tendon affections), neurological affection including (diabetic peripheral neuropathy, reflex sympathetic dystrophy) and vascular affection in the form of peripheral vascular disease. All patients were subjected to history taking and examination of the hand including (skin, small joints, wrists, muscles, tendons and neurological examination). Summary and Conclusion - ١٣٠ - In the present study, diabetic peripheral neuropathy was found in 76 (76%) hands. Diabetic yellow skin was found in 25 (25%), trigger finger was found in 3 (3%), peripheral arterial disease was found in 3 (3%), osteoarthritis was found in 2 (2%) hands and Dupuytren’s contracture was found in only 1(1%) hand. The other diabetic hand disorders that that were not found in our study included limited joint mobility and reflex sympathetic dystrophy. The manifestations of diabetes in the hand were much discussed in the 1970s and 1980s The term “diabetic hand” was coined to describe what was then felt to be the complications of diabetes mellitus in the hand, primarily limited joint mobility or stiff hand syndrome but also Dupuytren's contracture and trigger finger. Limited joint mobility was first described by Lundbaek in 1957 but popularized by Rosenbloom and Frias in 1974. Diabetic hand affection is underestimated. The present study aimed to reevaluate the diabetic hand and to discuss the clinical importance of the diabetic hand to increase our attention to the diabetic hand. Another studies will be required on a larger number of diabetic patients with more investigations to increase the awareness of the diabetic hand. We concluded that in our study the diabetic hand was present in more than two thirds of the diabetic patients and was correlated significantly with the duration of diabetes, Summary and Conclusion - ١٣١ - insulin treatment and retinopathy. Diabetic hand peripheral neuropathy being the most common diabetic hand complications followed by yellow skin, trigger finger, peripheral arterial disease, osteoarthritis then Dupuytren’s contracture .