Warning Signs: Occult Diabetes and Dysglycemia in the Hand Surgery Patient Population.
Document Type
Article
Publication Date
12-23-2022
Publication Title
Hand (N Y)
Abstract
BACKGROUND: Diabetes mellitus often exists for many years prior to diagnosis, and very little is known about the role of the prediagnosis stage of metabolic impairment in contributing to hand and upper-extremity pathology. The goal of this study is to determine the prevalence of undiagnosed glucose dysregulation in patients presenting with the 2 most commonly treated conditions of the hand and wrist.
METHODS: A retrospective study was performed of hand surgery patients with no established diagnosis of prediabetes or diabetes referred for a 2-hour glucose tolerance test according to American Diabetes Association criteria. Patients were divided into 3 groups: peripheral neuropathies, trigger finger, and controls with various upper-extremity diagnoses. Rates of undiagnosed prediabetes and diabetes were compared between groups, including subgroup analysis of patients based on unilateral or bilateral presentation. Binary logistic regression analysis was also used to calculate odds ratios for multiple variables.
RESULTS: Patients with neuropathy had a significantly higher incidence of undiagnosed dysglycemia compared with the control group. Of those patients, 51.3% were prediabetic and 12.8% were diabetic. The control group had significantly lower rates. Within the bilateral neuropathy patients, 59.6% had prediabetes and 15.4% had diabetes, versus 34.6% with prediabetes and 7.7% with diabetes in the unilateral group.
CONCLUSIONS: Hand surgeons encounter a patient population with high rates of undiagnosed prediabetes and diabetes, with some presentations as much as 6 times higher than the general population. Certain patient presentations should prompt appropriate diagnostic testing and referral, especially those presenting with bilateral compression neuropathy and elevated body mass index.
Volume
Online ahead of print.
First Page
15589447221142893
Last Page
15589447221142893
Recommended Citation
Nelson JT, Gay SS, Diamond S, Gauger M, Singer RM. Warning signs: occult diabetes and dysglycemia in the hand surgery patient population. Hand (N Y). 2022 Dec 23:15589447221142893. doi: 10.1177/15589447221142893. Epub ahead of print. PMID: 36564989.
DOI
10.1177/15589447221142893
ISSN
1558-9455
PubMed ID
36564989