It is known how diabetes mellitus can reduce hand and ankle joints range of motion and modify their posture. The aim of this study was to investigate using a new method how diabetes affects hand and foot posture in young Type 1 Diabetes Mellitus (T1DM).
We enrolled 20 young T1DM patients: (M/F:11/9), mean age 13,8±3,8 yrs, BMI 19,5±4,7 kg/m2, diabetes duration 4,6±3,6 yrs, mean HbA1c 8,2±1,2 %, and 46 young subjects practicing soccer and dance: (M/F:30/16), mean age 12,6±2,1 yrs, BMI 18,9±2,6 kg/m2. In these subjects, we evaluated hand posture (analysis of frontal plane image of Prayer sign test). In particular, the inclination of the fifth metacarpal and phalanges bones were evaluated in addition to the angles at the metacarpophalangeal and interphalangeal joints. Ankle joint mobility and posture were evaluated (inclinometer and sagittal plane image) with patients on lying and standing position.
The analysis of hand images showed the presence in diabetic patients of a higher extension of the fifth metacarpophalangeal joint (patients: 34,7±11,0°; control: 18,6±8,5°) and higher flexion of the proximal interphalangeal joint (patients: 11,0±5,1°; control: 0,4±9,8°).
In comparison to controls, the patientshowed a higher inclination of the fifth metacarpal joint (42,4±11,2° vs 34,4±8,4°; p<0,005) and a lower inclination of the proximal phalanx (4,9±6,0° vs 15,7±6,1°; p<0,001).
The results of this pilot study indicate that the metacarpophalangeal joint and the proximal interphalangeal joint take a different posture in patients with T1DM. Young patients with T1DM can show from the first years of disease onset abnormal posture of the hand.