Diabetic stiff hand syndrome

Diabetic stiff hand syndrome (DSHS), also known as Diabetic cheiroarthropathy, is a disorder in which thickening or tightening of the skin on the hands leads to limited finger movement. It is a common complication of diabetes, particularly type 1 diabetes, but can also occur in patients with type 2 diabetes.

Symptoms

The primary symptom of diabetic stiff hand syndrome is limited finger movement. This can make it difficult to fully extend the fingers or make a fist. Other symptoms may include waxy, thickened skin on the back of the hands, and occasionally on the fingers. The skin may also appear shiny and tight.

Causes

The exact cause of diabetic stiff hand syndrome is not known, but it is believed to be related to the high blood sugar levels associated with diabetes. High blood sugar can lead to the accumulation of advanced glycation end-products (AGEs) in the skin's collagen. AGEs can cause the collagen to become stiff and inflexible, leading to the symptoms of DSHS.

Diagnosis

Diabetic stiff hand syndrome is typically diagnosed based on the patient's symptoms and a physical examination. The prayer sign is a common diagnostic tool used to identify DSHS. In this test, the patient attempts to press their palms together in a prayer-like position. If the patient is unable to fully press their palms and fingers together, this may indicate the presence of DSHS.

Treatment

Treatment for diabetic stiff hand syndrome primarily involves managing the patient's blood sugar levels to prevent further accumulation of AGEs. Physical therapy and exercises can also help to improve hand flexibility and function. In severe cases, surgery may be required to release the tight skin.

See also

• Diabetes mellitus
• Diabetic neuropathy
• Diabetic foot

Rheumatologic diseases

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