Cleveland Clinic Journal of MedicineThe Clinical Picture: Stiff Hands in a Man with Type 1 Diabetes

Diabetic Cheiroarthropathy: A Common but Overlooked Complication of Diabetes with Potential Links to Microvascular Complications

Diabetic cheiroarthropathy, a complication of both type 1 and type 2 diabetes, is a condition that often goes unnoticed. This condition, characterized by stiffness and difficulty in flexing or extending the small joints of the hands, can lead to significant disability if not managed effectively. Despite its prevalence, it remains underdiagnosed and undertreated, highlighting the need for increased awareness and improved management strategies among healthcare professionals.

Key Points:

• Diabetic cheiroarthropathy is a recognized complication of type 1 and type 2 diabetes, occurring in 18.3% to 28.5% of patients with diabetes.
• The condition is characterized by the inability to completely flex or extend the small joints of the hand, along with the waxy and yellowish thickening of the palmar skin.
• Poor glycemic control is a major contributing factor to the development of this condition.
• The primary focus of treatment lies in improving glycemic control and implementing physical therapy.
• Symptom-targeted therapies like anti-inflammatory drugs, analgesics, and intralesional corticosteroids have limited effectiveness.
• Early recognition of this condition is crucial as it is often associated with diabetes-related microvascular complications.

Dupytren contracture mimics diabetic cheiroarthropathy and has been reported in 16% to 42% of patients with diabetes.

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