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An overlooked rheumatologic manifestation of diabetes: diabetic cheiroarthropathy

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Abstract

Objectives

The objectives of the study were to analyze the clinical characteristic of diabetic cheiroarthropathy (DCA) in patients with type 1 diabetes mellitus (DM), type 2 DM, and prediabetes and to evaluate the frequency of DCA among groups.

Method

The cross-sectional study was conducted at the Division of Endocrinology and Metabolism outpatient clinic over a 14-month period. A total of 239 patients (160 female, 79 male), who had type 1 DM, type 2 DM, and prediabetes, were enrolled. The demographics, clinical variables, and laboratory outcomes were recorded. Diabetic cheiroarthropathy was defined according to physical examination. The functional disability of patients with DCA was assessed by the self-administered questionnaire (disabilities of the arm, shoulder and hand-DASH).

Results

Diabetic cheiroarthropathy was determined in 35.1% of all patients. The frequency of DCA was higher in patients with prediabetes (x2 = 0.009, post hoc power = 0.794). According to the logistic regression analysis, prediabetes (OR = 4.52, 95% CI 2.16–9.47, p < 0.001), presence of polyneuropathy (OR = 3.82, 95% CI 1.61–9.07, p = 0.002), and fasting glucose level (OR = 1.01, 95% CI 1.00–1.01, p = 0.004) found as the most effective risk factors in determining DCA. DASH disability scores were significantly higher in prediabetic patients than that in type 2 DM group (p = 0.021).

Conclusion

High frequency of DCA and impaired hand function are observed in prediabetic patients. Musculoskeletal manifestations can emerge as an early sign of diabetic status. Also, people who suffer from hand involvement should be examined for diabetes along with rheumatologic diseases.

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Acknowledgements

The authors wish to thank Ilker Unal for his valuable contributions on statistical analysis.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Faculty of Medicine, Cukurova University, Adana, Turkey

    Neslihan Gokcen

  2. Department of Internal Medicine, Division of Endocrinology, Cukurova University, Faculty of Medicine, Adana, Turkey

    Seher Cetinkaya Altuntas & Murat Sert

  3. Department of Physical Medicine and Rehabilitation, Cukurova University, Faculty of Medicine, Adana, Turkey

    Ilke Coskun Benlidayi & Tunay Sarpel

  4. Department of Public Health, Cukurova University Faculty of Medicine, Adana, Turkey

    Ersin Nazlican

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  1. Neslihan Gokcen
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  2. Seher Cetinkaya Altuntas
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Correspondence to Neslihan Gokcen.

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Gokcen, N., Cetinkaya Altuntas, S., Coskun Benlidayi, I. et al. An overlooked rheumatologic manifestation of diabetes: diabetic cheiroarthropathy. Clin Rheumatol 38, 927–932 (2019). https://doi.org/10.1007/s10067-019-04454-z

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  • DOI: https://doi.org/10.1007/s10067-019-04454-z

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