Endocr Pract. 2019 Feb;25(2):138-143. doi: 10.4158/EP-2018-0346. Epub 2018 Nov 1.
Diabetic cheiroarthropathy is a long-term complication of diabetes that causes significant morbidity and can impair functional abilities. It has not been well studied in individuals with type 1 diabetes (T1D). The T1D Exchange registry provided an opportunity to assess the frequency of cheiroarthropathy and related characteristics.
An internet-based survey was sent to 6,199 registry participants ≥18 years old, with 1,911 (31%) responding (62% female, 90% non-Hispanic White, mean age 40 years, median diabetes duration 20 years, mean glycated hemoglobin [HbA1c] 7.7% [61 mmol/mol]).
A total of 586 (31%) adults reported a diagnosis of ≥1 upper extremity disorder: 293 (15%) reported frozen shoulder, 293 (15%) trigger finger, 261 (14%) carpal tunnel, and 92 (5%) Dupuytren contracture, with 281 (15%) reporting ≥2 disorders. Those with upper extremity joint disorders were more likely older ( P<.001) and had longer duration of diabetes ( P<.001) than those without. HbA1c levels at the time of survey completion were 7.6% in participants with cheiroarthropathy versus 7.8% (62 mmol/mol) in participants without cheiroarthropathy.
Cheiroarthropathy is common in adults with T1D. Additional research is needed to understand the pathogenesis and risk factors for this disorder. Standards of care for early recognition and treatment of diabetic cheiroarthropathy are also needed, particularly for adults with long-term diabetes. Improved awareness of cheiroarthropathy signs and symptoms of is needed so that patients can be identified and seek treatment before the condition causes disability.
BMI = body mass index; CGM = continuous glucose monitor; DCCT/EDIC = Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications; HbA1C = glycated hemoglobin; T1D = type 1 diabetes; T2D = type 2 diabetes.
糖尿病手病是糖尿病的一种长期并发症，会导致严重的发病率，并可能损害功能能力。它在 1 型糖尿病（T1D）患者中尚未得到很好的研究。T1D 交换注册处提供了评估手病发病率和相关特征的机会。
向 6199 名年龄在 18 岁以上的登记参与者发送了基于互联网的调查，其中 1911 名（31%）做出了回应（62%为女性，90%为非西班牙裔白人，平均年龄为 40 岁，中位糖尿病病程为 20 年，平均糖化血红蛋白[HbA1c]为 7.7%[61mmol/mol]）。
共有 586 名（31%）成年人报告了至少 1 种上肢疾病的诊断：293 名（15%）报告了冻结肩，293 名（15%）报告了扳机指，261 名（14%）报告了腕管疾病，92 名（5%）报告了掌挛缩，281 名（15%）报告了≥2 种疾病。与没有上肢关节疾病的参与者相比，有上肢关节疾病的参与者年龄更大（P<.001），糖尿病病程更长（P<.001）。在完成调查时，手病患者的 HbA1c 水平为 7.6%，而无手病患者的 HbA1c 水平为 7.8%（62mmol/mol）。
手病在 T1D 成人中很常见。需要进一步研究以了解这种疾病的发病机制和危险因素。还需要制定早期识别和治疗糖尿病手病的护理标准，特别是对于长期患有糖尿病的成年人。需要提高对手病体征和症状的认识，以便在病情导致残疾之前发现并治疗患者。
