Frozen shoulder, carpal tunnel syndrome, trigger finger and Dupuytren contracture are common in these patients.

Four upper extremity disorders – frozen shoulder, carpal tunnel syndrome, trigger finger and Dupuytren contracture – are common in patients with type 1 diabetes. In a survey of 2200 Danish patients (mean age, 56 years) with longstanding type 1 diabetes, researchers asked them whether healthcare providers had diagnosed any of those disorders.

The lifetime prevalences of receiving diagnoses of frozen shoulder, carpal tunnel syndrome, trigger finger and Dupuytren contractures were 31%, 22%, 25% and 15%, respectively; 55% of patients had one or more of these conditions. Each diagnosis was roughly twice as prevalent in these patients as in similarly aged control respondents without type 1 diabetes. Patients with histories of microvascular or macrovascular complications were substantially more likely to have these upper extremity conditions than were patients without vascular complications of diabetes.

Comment: These findings are strikingly similar to those from a previous report of upper extremity disorders in middle­-aged patients with type 1 diabetes (NEJM JW Gen Med Aug 15 2014 and Diabetes Care 2014; 37: 1863­-1869). The similarity is noteworthy because the methodologies were quite different: the previous report was a formal observational study with corroboration by physical examination. These data remind us to be proactive in asking patients with longstanding type 1 diabetes about pain, limited mobility and sensory or motor symptoms in the upper extremities.

Allan S. Brett, MD, Clinical Professor of Medicine, University of Colorado School of Medicine, Aurora, USA.

Wagner S, et al. Upper-extremity impairments in type 1 diabetes: results from a controlled nationwide study. Diabetes Care 2023; 46: 1204-1208.

This summary is taken from the following Journal Watch titles: General Medicine, Ambulatory Medicine.