title: Peripheral neuropathy in the hands of people with diabetes mellitus.
abstract: OBJECTIVE
  Peripheral sensorimotor neuropathy is a recognised complication of diabetes mellitus however little attention has been given to its development in the hands. The aim of this study was to determine the prevalence of sensory impairment in the hands of participants with diabetes, the agreement between two measurement tools for assessing sensation and the association between hand sensibility, age, glycaemic control and end-organ damage.
  
  
  METHODS
  A total of 162 participants were recruited and divided into two cohorts based on a diagnosis of diabetes. Participants were tested for the presence of hand neuropathy using Semmes-Weinstein monofilaments and the AsTex™. Medical records of participants with diabetes were accessed retrospectively to determine glycaemic control and diabetes complications.
  
  
  RESULTS
  A highly statistically significant association was found between neuropathy and diabetes status (P<0.001) on monofilament testing. The prevalence of neuropathy was 64% compared to ∼10% amongst participants without diabetes. Age, male gender and diabetic retinopathy were associated with neuropathy. The AsTex™ identified participants with diminished protective sensation on monofilament testing.
  
  
  CONCLUSIONS
  This study demonstrates a relationship between diabetes and upper limb neuropathy. Age, male gender and retinopathy were associated with diminished hand sensation. The AsTex™ may have a role as a screening tool for identifying clinically significant hand neuropathy.
authors.affiliation: School of Medicine, University of Notre Dame, Australia. Electronic address: samantha.ennis1@my.nd.edu.au.
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Ennis
authors.affiliation: Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Victoria 3010, Australia. Electronic address: m.galea@unimelb.edu.au.
authors.forename: Mary P
authors.initials: MP
authors.lastname: Galea
authors.affiliation: University of Melbourne Department of Medicine, St Vincent's Hospital Melbourne, 4th Floor Clinical Sciences Building, Fitzroy, Victoria 3065, Australia. Electronic address: dno@unimelb.edu.au.
authors.forename: David N
authors.initials: DN
authors.lastname: O'Neal
authors.affiliation: School of Medicine, University of Notre Dame, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dodson
mesh_terms: D000328:Adult; D015331:Cohort Studies; D048909:Diabetes Complications; D005260:Female; D006225:Hand / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000209:etiology*; D015995:Prevalence; D012189:Retrospective Studies
keywords: Diabetes; Hand; Peripheral neuropathy