Alterations of Hand Function in Type 2 Diabetes Mellitus Patients with and without Diabetic Peripheral Neuropathy
Julia Ahmad Kamal1, Ahmad Zamir Daud2, Haidzir Manaf
Background: Diabetes Mellitus (DM) is a common chronic diseases globally with increasing prevalence each year. Although the major outcomes of DM such as foot ulceration and amputation arise in the lower legs, various previous studies have shown that DM also cause deficits of sensorimotor function in the hands.
Aim: To investigate the effects of diabetic peripheral neuropathy (DPN) on hand function among patients with type 2 diabetes mellitus (T2DM).
Methods: Eighty-four T2DM patients with DPN, 84 T2DM patients without DPN, and 84 healthy controls participated in this cross-sectional study. This study was conducted at the Selayang Hospital, Selangor, Malaysia in February to July 2018. Tactile sensation was assessed using 10 g Semmes-Weinstein monofilaments. The wrist and finger joints were assessed using a goniometer, and grip strength was measured using the commercially available JAMAR hydraulic dynamometer. The nine-hole peg test was used to assess dexterity. The Jebsen hand function test was used to assess hand function activities during the performance of activities of daily living (ADL). The Kruskal-Wallis test was used to analyze the data parameters.
Results: There were significant differences in the magnitude of sensory function, range of motion, grip and pinch strength, dexterity, and ADL function of both thenar, hypothenar, and the first to fifth fingers between the three groups (p = 0.001).
Conclusion: The study showed that hand function was affected in T2DM patients with DPN. Further investigations are warranted to explore the impact of DPN on the muscle activity related to the performance of hand function in T2DM patients with DPN.
Keywords: Diabetes Mellitus, Diabetic Peripheral Neuropathy, Hand function, Manual Dexterity, Muscle strength