Limited joint mobility in diabetes mellitus
- Lesley D Hordon, MD
Lesley D Hordon, MD
- Consultant in Rheumatology
- University of Leeds, United Kingdom
- Section Editors
- David M Nathan, MD
David M Nathan, MD
- Editor-in-Chief — Endocrinology
- Section Editor — Diabetes Mellitus
- Professor of Medicine
- Harvard Medical School
- John S Axford, DSc, MD, FRCP, FRCPCH
John S Axford, DSc, MD, FRCP, FRCPCH
- Section Editor — Scleroderma
- Emeritus Professor of Rheumatology
- St George's University of London
Limited joint mobility (cheiroarthropathy) is common in patients with diabetes mellitus. It is characterized by limitation of joint movement that is most marked in the small joints of the hands [1,2]. Thickening and waxiness of the skin are also common, particularly on the dorsal surface of the fingers, but these skin changes may occur in the absence of limited joint mobility .
The prevalence of limited joint mobility in diabetes mellitus has ranged from 8 to 58 percent [1,4,5]. This variability depends largely upon the population studied and the way in which joint mobility is measured. Care must also be taken to avoid confusion with other diabetic hand problems such as Dupuytren's contracture, flexor tenosynovitis, trigger finger, and reflex sympathetic dystrophy, which may coexist  (see "Musculoskeletal complications in diabetes mellitus"). Limited joint mobility also occurs in the absence of diabetes, with prevalence figures varying between 12 and 25 percent in nondiabetic subjects of three studies [4,6,7].
Limited joint mobility occurs in both type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetes [4,6,7]. The risk increases with increasing glycated hemoglobin (A1C) values  and the duration of diabetes [4,9-11], although it can occur early in the course of the disease . The prevalence also increases with age and cigarette smoking in both diabetics and nondiabetics [7,12]. (See 'Associations with other diabetic complications' below.)
Two cross-sectional studies have investigated the prevalence of limited joint mobility in patients with diabetes over time:
●In children and adolescents between the ages of 7 to 18 years, the prevalence of limited joint mobility fell significantly from 31 percent to 7 percent, between 1976 to 1978 and 1988 .
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