Biochemical markers decrease and increase disproportionally in A1 pulley tissue of type 2 diabetic trigger finger patients

Bülent, Nazmi; Akdağ, Gökhan; Karduz, Gülsüm; Vardar, Kübra; Aksu, Uğur

doi:10.5606/ehc.2019.66112

Cited by 3 publications

(2 citation statements)

References 32 publications

(35 reference statements)

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“…In patients with DM, prolonged hyperglycaemia results in the formation of advanced glycation end products that accumulate in tendons, resulting in increased tissue stiffness. 27 Together with increased oxidative stress, 28 also in the A1-pulley among individuals with DM, 29 these pathological processes could possibly lead to a thicker tendon and a size mismatch between the tendon and the tendon sheet, resulting in the trigger phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Patient Experiences after Open Trigger Finger Release in Patients with Type 1 and Type 2 Diabetes—A Retrospective Study Using Patient-reported Outcome Measures

Rydberg

Zimmerman

Gottsäter

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Trigger finger is overrepresented among patients with diabetes mellitus (DM). Whether DM affects the outcome after open trigger finger release (OTFR) in patients with DM is not known. Our aim was thus to explore outcomes after OTFR in patients with type 1 (T1D) and type 2 DM (T2D). Methods: Data included patient-reported outcome measures (PROMs) from all OTFRs performed between 2010 and 2020 registered in the Swedish national registry for hand surgery in individuals over 18 years cross-linked with the Swedish National Diabetes Register (NDR). PROMs included QuickDASH and HQ8, a questionnaire designed for national registry for hand surgery, preoperative and at 3 and 12 months postoperative. HQ8 included pain on load, pain on motion without load, and stiffness. Outcome was calculated using linear-mixed models and presented as means adjusted for age and stratified by sex. Results: In total, 6242 OTFRs were included, whereof 496 had T1D (332, 67% women) and 869 had T2D (451, 52% women). Women with T1D reported more symptoms of stiffness (P < 0.001), and women with T2D reported more pain on load (P < 0.05), motion without load (P < 0.01), and worse overall result at 3 months. At 12 months, however, no differences were found in any of the HQ-8 PROMs among men or women. Women with T2D had slightly higher QuickDASH scores at 3 and 12 months. Conclusion: Patients with T1D and T2D can expect the same results after OTFR as individuals without DM, although the improvement might take longer especially among women with T2D.

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Section: Discussionmentioning

confidence: 99%

Patient Experiences after Open Trigger Finger Release in Patients with Type 1 and Type 2 Diabetes—A Retrospective Study Using Patient-reported Outcome Measures

Rydberg

Zimmerman

Gottsäter

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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show abstract

“…Finally, given the observational nature of the study, it is essential to note that we cannot establish causal inference or delineate specific pathophysiological mechanisms between CTS, TF and T2D, despite the results presented. Future studies should include prospective data, preferably including biopsies from individuals at high risk, possibly identifying early biochemical and histological changes in, for example, the carpal ligament, 30 tendon sheet, 31 posterior interosseous nerve, 32 or surrounding connective tissue. 33 Other potential confounding factors, such as symptom duration and severity, smoking, body mass index, and occupation, should preferably also be included in future studies, as these variables were not available in the registers used in this study.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Carpal Tunnel Syndrome and Trigger Finger May Be an Early Symptom of Preclinic Type 2 Diabetes

Rydberg,

Perez,

Merlo

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: Type 2 diabetes (T2D) is a major risk factor for carpal tunnel syndrome (CTS) and trigger finger (TF), but less is known regarding the risk of developing T2D after being diagnosed with CTS or TF. CTS and TF could be early signs of preclinical T2D, and early detection of T2D is crucial to prevent complications and morbidity. Therefore, we investigate the association between CTS/TF and T2D in an adult population without previous T2D using big data registers in Sweden. Methods: Data were collected by crosslinking five nationwide Swedish registers. Individuals aged 40–85 years on December 31, 2010, without prior overt diabetes, were included (n = 3,948,517) and followed up from baseline (ie, a diagnosis of CTS or TF) or January 1, 2011, for controls, until a diagnosis of T2D, prescription of oral antidiabetics or insulin, or end of follow-up four years after baseline. Multivariate Cox regression models were created to calculate hazard ratios for T2D. Results: In total, 37,346 (0.95%) patients were diagnosed with CTS, whereof 1329 (3.46%) developed T2D. There were 17,432 (0.44%) patients who developed TF, whereof 639 (3.67%) developed T2D. Among the controls, 2.73% developed T2D. Compared with controls, there was an increased risk of developing T2D after being diagnosed with either CTS (HR 1.35; 95% confidence interval 1.28–1.43) or TF (HR 1.21; 95% confidence interval 1.12–1.31). Conclusion: Compared with controls, a diagnosis of CTS or TF was associated with 35% and 21% higher risk for later T2D, respectively, which might indicate the existence of undetected T2D in this population.

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High HbA1c Levels Are Associated With Development of Trigger Finger in Type 1 and Type 2 Diabetes: An Observational Register-Based Study From Sweden

et al. 2022

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OBJECTIVE Trigger finger (TF) is a hand disorder causing the fingers to painfully lock in flexion. Diabetes is a known risk factor; however, whether strict glycemic control effectively lowers risk of TF is unknown. Our aim was to examine whether high HbA1c was associated with increased risk of TF among individuals with diabetes. RESEARCH DESIGN AND METHODS The Swedish National Diabetes Register (NDR) was cross-linked with the health care register of the Region of Skåne in southern Sweden. In total, 9,682 individuals with type 1 diabetes (T1D) and 85,755 individuals with type 2 diabetes (T2D) aged ≥18 years were included from 2004 to 2019. Associations between HbA1c and TF were calculated with sex-stratified, multivariate logistic regression models with 95% CIs, with adjustment for age, duration of diabetes, BMI, and systolic blood pressure. RESULTS In total, 486 women and 271 men with T1D and 1,143 women and 1,009 men with T2D were diagnosed with TF. Increased levels of HbA1c were associated with TF among individuals with T1D (women OR 1.26 [95% CI 1.1–1.4], P = 0.001, and men 1.4 [1.2–1.7], P < 0.001) and T2D (women 1.14 [95% CI 1.2–1.2], P < 0.001, and men 1.12 [95% CI 1.0–1.2], P = 0.003). CONCLUSIONS Hyperglycemia increases the risk of developing TF among individuals with T1D and T2D. Optimal treatment of diabetes seems to be of importance for prevention of diabetic hand complications such as TF.

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Biochemical markers decrease and increase disproportionally in A1 pulley tissue of type 2 diabetic trigger finger patients

Cited by 3 publications

References 32 publications

Patient Experiences after Open Trigger Finger Release in Patients with Type 1 and Type 2 Diabetes—A Retrospective Study Using Patient-reported Outcome Measures

Patient Experiences after Open Trigger Finger Release in Patients with Type 1 and Type 2 Diabetes—A Retrospective Study Using Patient-reported Outcome Measures

Carpal Tunnel Syndrome and Trigger Finger May Be an Early Symptom of Preclinic Type 2 Diabetes

High HbA1c Levels Are Associated With Development of Trigger Finger in Type 1 and Type 2 Diabetes: An Observational Register-Based Study From Sweden

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