Diabetic Neuropathy in Hands: An Endemic Complication Waiting to Unfold?

Author:

Sierra-Silvestre Eva123ORCID,Andrade Ricardo J.24ORCID,Schroeter Andrea C.2ORCID,Bisset Leanne12ORCID,Coppieters Michel W.23ORCID

Affiliation:

1. 1School of Health Sciences, Griffith University, Brisbane and Gold Coast, Australia

2. 2Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Australia

3. 3Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

4. 4Movement, Interactions, Performance Laboratory, Nantes Université, Nantes, France

Abstract

In this cross-sectional study we aimed to quantify the somatosensory dysfunction in the hand in people with diabetes with distal symmetrical polyneuropathy (DSPN) in hands and explore early signs of nerve dysfunction in people with diabetes without DSPN in hands. The clinical diagnosis of DSPN was confirmed with electrodiagnosis and corneal confocal microscopy. Thermal and mechanical nerve function in the hand was assessed with quantitative sensory tests. Measurements were compared between healthy participants (n = 31), individuals with diabetes without DSPN (n = 35), individuals with DSPN in feet but not hands (DSPNFEET ONLY) (n = 31), and individuals with DSPN in hands and feet (DSPNHANDS & FEET) (n = 28) with one-way between-group ANOVA. The somatosensory profile of the hand in people with DSPNHANDS & FEET showed widespread loss of thermal and mechanical detection. This profile in hands is comparable with the profile in the feet of people with DSPN in feet. Remarkably, individuals with DSPNFEET ONLY already showed a similar profile of widespread loss of nerve function in their hands. People with diabetes without DSPN in feet already had some nerve dysfunction in their hands. These findings suggest that nerve function assessment in hands should become more routine in people with diabetes.

Publisher

American Diabetes Association

Subject

Endocrinology, Diabetes and Metabolism,Internal Medicine

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