title: Evaluation of dexterity in insulin-treated patients with type 1 and type 2 diabetes mellitus.
abstract: BACKGROUND
  Daily routine for insulin-treated patients with diabetes mellitus requires correct performance of self-monitoring of blood glucose and insulin injections several times a day. Dexterity skills may play an important role in the performance efficacy of these procedures.
  
  
  METHODS
  We collected data of insulin-treated (>10 years) patients with different age ranges [healthy controls, 14 female/11 male, age (mean ± standard deviation) 55 ± 7 years; type 1 diabetes mellitus (T1DM) patients, 12/13, 45 ± 9 years, disease duration 23.9 ± 6.5 years; T2DM patients, 8/17, 64 ± 6 years, 16.2 ± 6.9 years; T2DM patients (>70 years of age), 9/16, 75 ± 4 years, 19.7 ± 7.0 years]. After assessment of neuropathy (temperature, pain, and vibration perception), the patients participated in two dexterity test batteries [Jebsen-Taylor hand-function test (JHFT) and motoric performance series (MPS)].
  
  
  RESULTS
  Patients with type 2 diabetes showed disturbed vibration perception as compared to the other groups. The dexterity results were influenced by age to a large extent. Older T2DM patients performed worst in the majority of the subtests (e.g., JHFT, writing nondominant hand: control, 40.8 ± 11.7 s; T1DM, 46.3 ± 50.9 s, not significant versus control; old T2DM, 68.1 ± 29.5 s, p < .05; young T2DM, 52.5 ± 26.2 s, p < .05). Patients with type 1 diabetes showed similar JHFT and MPS results than the 10-year-older control subjects and performed outside of the age-dependent normal reference range.
  
  
  CONCLUSIONS
  Manual skills and dexterity differed between the groups, and age-corrected reduced skills were common in both T1DM and T2DM patients in this study. Our findings underline the importance of considering dexterity and manual skills when designing medical devices for patients with diabetes mellitus.
authors.affiliation: IKFE, Institute for Clinical Research and Development, Mainz, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Pfützner
authors.forename: Juliane
authors.initials: J
authors.lastname: Hellhammer
authors.forename: Petra
authors.initials: P
authors.lastname: Musholt
authors.forename: Anke H
authors.initials: AH
authors.lastname: Pfützner
authors.forename: Jan
authors.initials: J
authors.lastname: Böhnke
authors.forename: Hero
authors.initials: H
authors.lastname: Torsten
authors.forename: Ildiko
authors.initials: I
authors.lastname: Amann-Zalan
authors.forename: Manfred
authors.initials: M
authors.lastname: Ganz
authors.forename: Thomas
authors.initials: T
authors.lastname: Forst
authors.forename: Andreas
authors.initials: A
authors.lastname: Pfützner
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004526:Efficiency / Q000502:physiology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007267:Injections; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D011597:Psychomotor Performance
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin