Aims: To observe the natural history of hand function during a two-year period in partidpants with hand syndromes assodated with diabetes and to determine factors related to changing function
Methods: Hand function was measured over three annual visits using Disability of the Arm. Shoulder and Hand (DASH) and SF-36v2 questionnaires, grip strength. light touch and 9-hole peg tests. Ught touch was tested with WEST monofilaments at 7 sites on the hand (srore 35 to 0).Data were analyzed using repeated measures ANOVA. Spearman's correlation, and Wilcoxon signed-rank tests.
Results: Partidpants (n=60) were aged 61±10.5 years,57% female, diagnosed with diabetes and at least one of four assodated hand disorders.Presentations of carpal tunnel syndrome, or past release (n = 27, 45%) and trigger finger (n=24, 40%) were common. Tactile sensation was reduced during the two-year period (median, range; 30 months, 25-40 months). Initial median (inter-quartile range) scores for the dominant hand of25.5 (22-28.5) were reduced to 23 (21.5-27).This sensory loss was weakly assodated with HbA1c (r=0.30, p= 0.05) and occurred predominantly in partidpants with trigger finger (p=0.05).
Conclusions: Ught touch perception was reduced in longstanding diabetic hand syndromes. Tactile abnormalities that were detected by clinical examination progressed during a two year period and were related to metabolic control and musculoskeletal diagnosis.