title: Impacts of elevated glycaemic haemoglobin and disease duration on the sensorimotor control of hands in diabetes patients.
abstract: BACKGROUND
  To understand the impacts of disease chronicity and hyperglycaemia on sensorimotor control of hands of diabetic patients, this study investigated the differences in hand sensation, strength and motor control by applying the pinch-holding-up activity test for patients with diabetes mellitus (DM) with different levels of glycaemic control and disease chronicity.
  
  
  METHODS
  One hundred and fifty-nine patients with clinically defined DM were included. Semmes-Weinstein monofilament, static two-point discrimination and moving two-point discrimination, maximal pinch strength precision pinch performance tests and nerve conduction studies (NCS) of the subjects were carried out. Forty-seven (29.6%) patients were in the HbA(1c) < 7% category, and 112 (70.4%) patients were in the >7% group. There were 87 (54.7%) patients with the disease duration <10 years, and 72 (45.3%) patients with disease duration ≧10 years.
  
  
  RESULTS
  The severity of hyperglycaemia significantly impacts the results for Semmes-Weinstein monofilament, precision pinch force control, sensory and motor NCS tests (p < 0.05). In addition, the chronicity of disease influences the motor control of precision pinch performance and the amplitude of motor NCS (p < 0.05) for the diabetes patients.
  
  
  CONCLUSIONS
  The evidence suggests that disease chronicity and hyperglycaemia have impacts on sensorimotor control in the hands of DM patients. In addition, the efficiency of prehensile forces of hand-to-object interactions in the pinch-holding-up activity test could be significant for identifying hand function, as well as pathologic changes in median nerve function, for patients with DM.
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Hsiu-Yun
authors.initials: HY
authors.lastname: Hsu
authors.forename: Haw-Yen
authors.initials: HY
authors.lastname: Chiu
authors.forename: Hwai-Ting
authors.initials: HT
authors.lastname: Lin
authors.forename: Fong-Chin
authors.initials: FC
authors.lastname: Su
authors.forename: Chieh-Hsiang
authors.initials: CH
authors.lastname: Lu
authors.forename: Li-Chieh
authors.initials: LC
authors.lastname: Kuo
mesh_terms: D000368:Aged; D003920:Diabetes Mellitus / Q000503:physiopathology / Q000628:therapy; D003929:Diabetic Neuropathies / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D056228:Feedback, Sensory; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006225:Hand; D018737:Hand Strength; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D020423:Median Neuropathy / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D009048:Motor Skills; D009431:Neural Conduction; D052581:Pinch Strength; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology; D015854:Up-Regulation
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: diabetes mellitus; hyperglycaemia; neuropathy; pinch force adjustment