title: Hand syndromes associated with diabetes: impairments and obesity predict disability.
abstract: OBJECTIVE
  We determined patterns of disability in diabetic hand conditions and identified factors that contributed to functional limitations.
  
  
  METHODS
  Hand assessments were performed on 60 adults with DM1 or DM2 and carpal tunnel syndrome, trigger finger, Dupuytren's disease, or the syndrome of limited joint mobility. The examination included measurement of grip strength, light touch perception, and dexterity, as well as self-reported function using the Disabilities of the Arm, Shoulder and Hand (DASH) instrument and the Medical Outcomes Study Short Form-36 questionnaire. Associations with hand disability were analyzed using correlation and regression.
  
  
  RESULTS
  The most frequent presentation was carpal tunnel syndrome (45%) but it was common for patients to present with clinical features associated with more than one hand syndrome (47%). Overall, women had greater difficulties, with significantly higher DASH scores than men [mean 30.3 (95% CI 23.2, 37.5) vs 18.0 (95% CI 12.1, 23.9), respectively; p = 0.01]. Grip strength, dexterity, and obesity were associated with hand disability (p < 0.05).
  
  
  CONCLUSIONS
  In adults with hand syndromes associated with diabetes, disability was related to impaired muscle function and carpal tunnel syndrome. Obesity and overall physical functioning influenced hand disability, particularly in women.
authors.affiliation: University of Adelaide, Discipline of Medicine, Modbury Hospital, Modbury, Australia. christine.redmond@adelaide.edu.au
authors.forename: Christine L
authors.initials: CL
authors.lastname: Redmond
authors.forename: Gregory I
authors.initials: GI
authors.lastname: Bain
authors.forename: Laura L
authors.initials: LL
authors.lastname: Laslett
authors.forename: Julian D
authors.initials: JD
authors.lastname: McNeil
mesh_terms: D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013577:Syndrome