title: Relationship between limited joint mobility of the hand and diabetic foot risk in patients with type 2 diabetes.
abstract: BACKGROUND
  Foot ulceration is a serious problem for patients with type 2 diabetes (T2D), and the early detection of risks for this condition is important to prevent complications. The present cross-sectional study in T2D patients determined the relationship between limited joint mobility (LJM) of the hand and diabetic foot risk classified using the criteria of the International Working Group on the Diabetic Foot (IWGDF).
  
  
  METHODS
  Relationships between LJM of the hand and foot risk according to IWGDF category, HbA1c, age, body mass index, blood pressure, estimated glomerular filtration (eGFR), and diabetic complications (including diabetic peripheral neuropathy [DPN] and peripheral arterial disease [PAD]) were evaluated in 528 consecutive T2D patients. Poor glycemic control was defined as HbA1c ≥ 7%.
  
  
  RESULTS
  Patients with LJM of the hand were older and had a longer duration of diabetes, a higher prevalence of diabetic complications, including DPN and PAD, and a higher IWDGF category (all P < 0.001). Multivariate logistic regression analysis revealed that the foot risk assessed with IWDGF category was correlated with age (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01-1.06; P = 0.001), poor glycemic control (OR 1.66; 95% CI 1.00-2.77; P = 0.04), eGFR (OR 0.98; 95% CI 0.97-0.99; P = 0.02), and the presence of LJM of the hand (OR 3.86; 95% CI 2.21-6.86; P < 0.001).
  
  
  CONCLUSIONS
  The results demonstrate a correlation between LJM of the hand and foot risk. Diagnosis of diabetic hand is simple and non-invasive, and is thus a useful method for assessing the risk of diabetic foot in T2D patients.
authors.affiliation: Department of Internal Medicine, Otsu Municipal Hospital, Otsu, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Mineoka
authors.affiliation: Department of Internal Medicine, Otsu Municipal Hospital, Otsu, Japan.
authors.forename: Michiyo
authors.initials: M
authors.lastname: Ishii
authors.affiliation: Department of Internal Medicine, Otsu Municipal Hospital, Otsu, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Tsuji
authors.affiliation: Department of Internal Medicine, Otsu Municipal Hospital, Otsu, Japan.
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Komatsu
authors.affiliation: Department of Nursing, Otsu Municipal Hospital, Otsu, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Katayama
authors.affiliation: Department of Nursing, Otsu Municipal Hospital, Otsu, Japan.
authors.forename: Mitsuko
authors.initials: M
authors.lastname: Yamauchi
authors.affiliation: Department of Nursing, Otsu Municipal Hospital, Otsu, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Yamashita
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Yoshitaka
authors.identifier: http://orcid.org/0000-0002-8794-0550
authors.initials: Y
authors.lastname: Hashimoto
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: Department of Orthopedics, Uji Takeda Hospital, Uji, Japan.
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Katsumi
authors.affiliation: Department of Internal Medicine, Otsu Municipal Hospital, Otsu, Japan.
authors.forename: Motohide
authors.initials: M
authors.lastname: Isono
authors.affiliation: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Fukui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D017719:Diabetic Foot / Q000453:epidemiology*; D003928:Diabetic Nephropathies / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000453:epidemiology; D005260:Female; D050823:Hand Joints / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007592:Joint Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors
keywords: clinical practice; complication(s); diabetic hand; foot; limited joint mobility; 临床实践; 关节活动受限; 并发症; 糖尿病手; 足