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High A1c increases trigger finger risk in both diabetes types


high A1c Levels are associated with the development of ‘.trigger finger“Type 1 and type 2 diabetesresearchers find.

Officially Trigger Finger flexor muscle constriction Tenosynovitis, is a common disorder that affects both the flexor tendons and the tight pulleys that surround them, causing the fingers to flex and lock when manually pulled back, causing a snap, or “trigger.” A possible cause is a combination of tendinopathy and thickening of the trochlear.

Diabetes is a known risk factor for developing trigger fingers, but this new study, based on two Swedish population databases, is the largest to date to investigate the relationship. It’s the first time I’ve looked at gender.

The findings suggest that “optimal treatment of diabetes appears to be important in preventing diabetic hand complications such as trigger fingers.” It was published of diabetes care.

and Previous research Published in early 2022, based on the same Swedish dataset, Rydberg and colleagues found that the ‘diabetic hand’ phenomenon includes the previously recognized trigger finger and Dupuytren’s disease, and carpal tunnel syndromeulnar nerve entrapment, and possibly Osteoarthritis 1st carpometacarpal joint – all common conditions in people with any type of diabetes, especially type 1 diabetesthan those without diabetes.

“As a hand surgeon, I think clinicians should constantly screen for hand problems in people with diabetes. It’s a simple question: ‘Do you have a problem with your hands?’ And I can ask a question in two seconds.Of course heart, eye and kidney problems are more important, but I’m also very worried about stuck fingers and not being able to use my hands,” Rydberg said. rice field. Medscape Medical News.

The relationship between diabetes and the index finger may be driven by a combination of oxidative stress from diabetes-induced hypoxia, intracellular hyperosmotic proteins that cause edema, and formation of advanced glycation endproducts resulting from prolonged hyperglycemia. . “When you do the surgery, you can see the inside of the tendons…they’re inflamed and everything is a little swollen. Especially he has type 1 diabetes,” Rydberg said.

The ring finger can be treated with corticosteroid injections or surgical release of the A1 pulley. Injections, which often cause a dramatic temporary rise in blood sugar levels, are not always a permanent treatment.This is especially true in people who have had diabetes for a long time or who have multiple trigger fingers. [following injections] in those individuals. I don’t know if the data supports that, but that’s my clinical experience.

People with diabetes tend to recover from trigger release surgery a bit slower than people without diabetes, and they may experience more pain and stiffness in their fingers, but after a year there is no difference. I can tell them that it may take time but they will recover,” he said. Medscape Medical News.

Trigger finger, direct relation to A1c

The study population included 9,682 adults with type 1 diabetes and 85,755 with type 2 diabetes from the Swedish National Diabetes Registry from 2004 to 2019. These data are cross-linked with data from the Regional Skane Health Care Database containing all diagnoses in 1.1 million adults. During the study period, trigger finger was diagnosed in 486 women and 271 men with type 1 diabetes and 1,143 women and 1,009 men with type 2 diabetes.

Mean A1c in patients with type 1 or type 2 diabetes was higher in both men and women diagnosed with pressure finger during the study period compared to those without (all P. < .01).

Both men and women diagnosed with trigger finger had longer duration of diabetes in both type 1 and type 2 diabetes (both P. < .01). This association was significant both for A1c as a continuous variable and when divided into tertiles by mean A1c, even after adjusting for confounders such as age, smoking, duration of diabetes, body mass index and blood pressure. was significant.

The greatest risk of trigger finger was an odds ratio of 5.33 (P. < .001) were compared with men with type 1 diabetes who had A1c levels ≤ 48 mmol/mol (6.5%).

Rydberg plans to investigate the predictive value of trigger fingers. metabolic syndrome It aims to identify specific populations that may benefit from diabetes screening. He is also investigating various aspects of other diabetes-related hand complications, such as carpal tunnel syndrome and ulnar nerve entrapment. increase.

Rydberg is No related financial relationships have been reported.

diabetes care. Published online on August 25, 2022. full text

Miriam E. Tucker is a freelance journalist based in Washington, DC. She is a regular contributor to her Medscape, and her other work appears in her The Washington Post, her Shots blog on NPR, and Diabetes Forecast magazine. She uses @MiriamETucker on her Twitter.

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