Deteriorating tactile sensation in patients with hand syndromes associated with diabetes: a two-year observational study.
OBJECTIVE
To observe the natural history of hand function during a two-year period in participants with hand syndromes associated with diabetes and to determine factors related to changing function.


METHODS
Hand function was measured over three annual visits using Disability of the Arm, Shoulder and Hand (DASH) and SF-36v2 questionnaires, grip strength, light touch and 9-hole peg tests. Light touch was tested with WEST monofilaments at 7 sites on the hand (score 35 to 0). Data were analyzed using repeated-measures ANOVA, Spearman's correlation, and Wilcoxon signed-rank tests.


RESULTS
Participants (n=60) were aged 61 ± 10.5 years, 57% female, diagnosed with diabetes and at least one of four associated hand disorders. Presentations of carpal tunnel syndrome, or past release (n=27, 45%) and trigger finger (n=24, 40%) were common. Tactile sensation was reduced during the two-year period (median, range; 30 months, 25-40 months). Initial median (inter-quartile range) scores for the dominant hand of 25.5 (22-28.5) were reduced to 23 (21.5-27). This sensory loss was weakly associated with HbA1c (r=0.30, p=0.05) and occurred predominantly in participants with trigger finger (p=0.05).


CONCLUSIONS
Light touch perception was reduced in longstanding diabetic hand syndromes. Tactile abnormalities that were detected by clinical examination progressed during a two year period and were related to metabolic control and musculoskeletal diagnosis.
University of Adelaide, Discipline of Medicine, Modbury Hospital, Smart Road, Modbury, 5092, Australia. christine.redmond@adelaide.edu.au
Christine L
CL
Redmond
Gregory I
GI
Bain
Laura L
LL
Laslett
Julian D
JD
McNeil
D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000453:epidemiology / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D004185:Disability Evaluation; D018450:Disease Progression; D004387:Dupuytren Contracture / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000503:physiopathology*; D018737:Hand Strength / Q000502:physiology; D006304:Health Status; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D014110:Touch / Q000502:physiology*; D055698:Touch Perception / Q000502:physiology; D052582:Trigger Finger Disorder / Q000453:epidemiology / Q000503:physiopathology*