Diabetes is a systemic condition with multiple areas involved. These can range from eye, kidney and circulation problems, as well as nerve issues. The “diabetic foot” has always been a concern for patients and their doctors, but the diabetic hand has not gained enough recognition as yet. The diabetic hand includes diabetic-related conditions like (LJM) or limited joint mobility, but also non diabetic conditions like trigger finger, carpal tunnel compression and Dupuytren’s contracture.
LJM is also known as diabetic stiff hand syndrome or cheiroarthropathy and has been found in up to 50% of Type 1 diabetics. It is a painless, non disabling condition due to stiffness and thickening of the tissues around joints. Typically patients complain of stiff knuckles, and small joints of the fingers spreading from the little finger to the thumb. There is no specific trauma or injury involved, rather it is a progressive condition. The “preacher’s sign” as illustrated below. 
(photo courtesy of www.arthritis-rheumatism.com)
LJM in itself is more a functional limitation for patients, but it does have systemic implications. In patients with LJM there is a 3-4 times increased risk of diabetic retinopathy, nephropathy and neuropathy. Treatment of the diabetic hand is largely dependent on tight blood sugar control. Patients with well controlled diabetes and low HbA1C tend not to develop LJM. Surgical release of joints is quite invasive and would need to address all affected joints. Despite this it may not restore a “normal” hand posture.
If you or someone you know is looking for more information on diabetic hand, please feel free to contact us on (02) 95252055 or email us at doctorjai@optusnet.com.au
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