“Diabetic hand”: Hand complications in people with diabetes

Abstract

Context: Distal and symmetrical diabetic peripheral neuropathy affects the feet first, and later, the hands. Its natural history may conclude in diabetic foot syndrome. It is one of the most frequent diabetes complications. This raises the question of which are the most common hand complications in people with diabetes and whether hand and foot complications share similar physio pathological mechanisms.

Objective: To analyze the most frequent hand problems in people with diabetes and their similarities and differences compared with those of diabetic foot syndrome.

Methodology: A search of indexed scientific literature was conducted.

Results: Hand problems are more frequent in people with diabetes than in the general population. They are associated with microvascular complications, especially retinopathy, longer disease duration, and poor glycemic control. Diabetes is neither a cause nor a risk factor for hand deformities; however, frequent causes include trauma and compression neuropathies. The most common extra-articular hand problems in people with diabetes are: 1) diabetic cheiroarthropathy (hand rigidity or limitation of articular mobility); 2) the compression or entrapment neuropathies, of which the most common is carpal tunnel syndrome; and 3) fibroproliferative disorders (trigger finger and Dupuytren’s contracture). Management focuses on improving glycemic control, alleviating pain, and preserving or improving function.

Conclusions: Hand problems in people with diabetes are musculoskeletal disorders and have a different etiology from that of diabetic microvascular complications.