Do we underestimate influences of diabetic mononeuropathy or polyneuropathy on hand functional performance and life quality?

Abstract

Aims/IntroductionThe purpose of the present study was to identify whether there are differences in hand dexterity, hand functional performance and quality of life between diabetes patients with mononeuropathy and polyneuropathy of their hands to further present the importance regarding the impacts of diabetic neuropathic deficits on patients’ functional capacity.Materials and MethodsThe neurological deficits of 127 patients with type 2 diabetes were examined by electrophysiological tests for the median and ulnar nerves, and were stratified into the diabetic mononeuropathy, diabetic polyneuropathy and non‐diabetic neuropathy groups by sensory amplitude of these nerves. The Purdue pegboard test, Michigan Hand Outcomes Questionnaire, and Diabetes‐39 were carried out to understand patients’ hand dexterity, functional hand performance and quality of life, respectively.ResultsThe results showed significant differences in all subtests of the Purdue pegboard test among the three groups. Furthermore, aesthetics, patient's satisfaction of the Michigan Hand Outcomes Questionnaire and diabetes control, sexual functioning, energy, and mobility of the Diabetes‐39 also showed significant differences among the three groups.ConclusionsThe present study shows the patients with polyneuropathy suffer from more negative impacts on hand functional performance and quality of life than those with mononeuropathy and without neuropathy. These findings might assist both patients and clinicians in better realizing the impacts of neuropathic hands, and planning suitable strategies of intervention or health education to prevent declines in hand functions.

Diabetic neuropathy is a generalized phenomenon with impact on hand functional performance and quality of life

“…That we found a similar pattern of sensory profiles and deficits in the hands compared to the feet underlines the highly underrecognized systemic nature of DSPN, by which not only all nerve fiber types [40] but also both upper and lower extremities can be affected. To recognize this systemic aspect is of clinical importance, because UL‐N not only has a strong impact on the patients' hand functional performance, but can also severely affect his/her daily living and QoL [13, 18]. Notably, neuropathic symptoms in the hands are not yet systematically assessed in the NDS and NSS.…”

Diffusion Tensor Imaging of the Sciatic Nerve as a Surrogate Marker for Nerve Functionality of the Upper and Lower Limb in Patients With Diabetes and Prediabetes

“…In contrast to the progression of clinical symptoms, recent studies applying high-resolution magnetic resonance neurography (MRN) at three Tesla (3T) have come to show that nerve lesions predominate proximally at the level of the sciatic nerve and that the sciatic nerve’s fractional anisotropy (FA), a dimensionless quantity for directed diffusion in nerve tissue, is a highly sensitive parameter for structural nerve damage in patients with diabetic neuropathy in previous clinical studies ( Vaeggemose et al, 2017b ; Jende et al, 2019 , 2020a ). Despite the assumption that length-dependent nerve damage in DN starts at the level of the feet and progresses to further proximally with an involvement of the upper limbs at later stages, recent studies revealed that sensory and motor functions of the upper limb are frequently affected already at early stages of DN but often remain undiagnosed until a certain degree of functional impairment becomes apparent, indicating that the progression of nerve fiber damage at the level of the hands and arms may parallel the progression of nerve fiber damage at the level of the feet and legs ( Kopf et al, 2018a ; Yang et al, 2018 ).…”

Effect of diabetes and diabetes complications on hand dexterity and quality of life – a quantitative study

“…The current study shows that 84% of respondents had at least one complication which confirms the literature data. Kurpas et al [16] report 81% of patients with complications of diabetes, Chien-Ju et al [17] confirm that 58-82% of patients with diabetes had neuropathy confirmed by electrophysiologic tests. Neuropathy within the hands was reported by as many as 92.8% of the participants.…”

“…Further research in this direction was carried out by Chien-Ju Yang et al [17] who confirmed that the quality of life of patients with polyneuropathy was significantly lower than patients with mononeuropathy. Patients without neuropathy had the highest quality of life.…”