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

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.

Automated summary

This cross-sectional study aimed to assess the somatosensory dysfunction in the hand in individuals with diabetes with distal symmetrical polyneuropathy (DSPN) and explore early signs of nerve dysfunction in individuals with diabetes without DSPN. The results showed that individuals with DSPN in both hands and feet had widespread loss of thermal and mechanical detection function in their hands, which was comparable to the profile seen in the feet of individuals with only DSPN in feet. Remarkably, individuals with only DSPN in feet already showed similar loss of nerve function in their hands. These findings highlight the importance of routine nerve function assessments in the hands of individuals with diabetes.