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

Abstract

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.

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

“…4,13 In diabetes-induced TF, thickening of both the tendons and tendon sheet as well as inflammation in the tenosynovium has been proposed as biochemical explanatory alterations, resulting in the high prevalence of TF among individuals with diabetes. 3,14 Nevertheless, as previously mentioned, far less is known about the temporality between the development of T2D after the onset of CTS or TF. Diabetes-induced pathobiological alterations in the nerve and ligaments could possibly be seen long before an established diagnosis of T2D, in analogy with peripheral neuropathy in lower limb, 12 retinopathy and cardiovascular complications, 15 and thus act as a warning sign for poor glycemic control and possibly also hyperlipidemia, another proposed risk factor for neuropathy.…”

Hands in diabetes

“…Trigger finger was more common with longer diabetes duration 9 . The risk of trigger finger rises with higher HbA 1c 10 …”

Therapeutic effect and rebound evaluation of dapagliflozin on glycated hemoglobin (HbA1c) in type 1 diabetes mellitus patients

“…It is interesting to note that research results suggest that dapagliflozin is a promising adjunct treatment to insulin which improves glycemic control in patients with inadequately controlled T1DM ( Dandona et al, 2017 ; Mathieu et al, 2018 ; Parkinson et al, 2019 ; Araki et al, 2020 ; Araki et al, 2021 ; Biester et al, 2021 ); meanwhile, it significantly decreases the glycated hemoglobin (HbA1c) ( Li et al, 2022 ). HbA1c identifies average plasma glucose concentration, and for people with diabetes this is important as the higher the HbA1c, the greater the risk of developing diabetes-related complications ( Rydberg et al, 2022 ; Wikstrom et al, 2022 ). However, the actual drug efficacy of dapagliflozin on HbA1c and whether there is a rebound from dapagliflozin efficacy on HbA1c remain unknown and thus cannot effectively guide an appropriate use of clinical medication.…”