Diabetes mellitus (DM) is impaired insulin secretion and peripheral insulin resistance that results in hyperglycemia. Early symptoms include polyuria, polyphagia, and blurred vision. Later complications include vascular disease, peripheral neuropathy, and vulnerability to infection. The patient is diagnosed via plasma glucose measurements, and complications can be minimized with adequate glycemic control. Patients with DM are at higher risk for several hand disorders, including carpal tunnel syndrome (CTS), Dupuytren’s disease (DD), trigger finger, and limited joint mobility (LJM). Collectively, these conditions are known as “diabetic hand,” because they occur so frequently in patients with DM. Thus, hand surgeons should obtain a detailed history and ask their patients about DM. If surgery is required, glycemic control during the procedure is imperative, as intraoperative hyperglycemia increases the risk of cardiovascular and respiratory problems, as well as infection. Post-operative glycemic control is just as crucial. Patients with DM are at higher risk of surgical complications and DM can have a negative effect on postsurgical outcomes.
Incidence and Related Conditions
Reproduced from the International statistical classification of diseases and related health problems, 10th revision, Fifth edition, 2016. Geneva, World Health Organization, 2016 https://apps.who.int/iris/handle/10665/246208