Hand grip strength in patients with type 2 diabetes mellitus

doi:10.1016/j.diabres.2005.03.028

Diabetes Research and Clinical Practice

Volume 70, Issue 3, December 2005, Pages 278-286

https://doi.org/10.1016/j.diabres.2005.03.028 Get rights and content

Abstract

Aim

The aim of the present study was to compare hand grip strength and pinch power, which are important parameters of hand function, in 76 patients with type 2 diabetes mellitus (T2DM) (mean age: 50.11 ± 7.6) with 47 non-diabetic control subjects (mean age: 46.93 ± 10.2).

Methods

Grip strength was assessed with a Jamar dynamometer and pinch power was measured with a pinch gauge. Body composition was measured using a Tanita body composition analyzer. Mann–Whitney test, chi-square test, Fisher's exact test, T-test, Kruskal–Wallis variance analysis, Wilcoxon's signed rank test and Pearson's correlation coefficients were used to determine the differences and relations between groups. A p-value <0.05 was taken as statistically significant.

Results

Hand grip strength test values were significantly lower in the diabetic group compared with the control group. Key pinch power value for the right hand was significantly lower in the diabetic group than in the control group whereas the left hand value was similar.

Conclusion

Hand grip strength and key pinch power values were found to be lower in patients with T2DM than in age-matched control subjects. Hands, as well as feet, are also affected by diabetes and physicians should be aware of this.

Introduction

Type 2 diabetes mellitus (T2DM), is the most common endocrine disorder worldwide, and it is characterized by metabolic abnormalities and by chronic complications involving the eyes, kidneys, nerves, and blood vessels [1]. These complications can cause morbidity and premature mortality, and lead to serious social and cause economic problems due to loss of employment.

Foot ulcers and joint problems in T2DM are the most significant causes of morbidity and admittance to orthopedic outpatient clinics. The major predisposing cause is diabetic polyneuropathy because the sensory denervation impairs the perception of trauma after wearing ill-fitting shoes. Alterations in proprioception may give rise to an abnormal pattern of weight bearing and sometimes to the development of Charcot's joints. In addition to sensory neuropathy, motor neuropathy is often emphasized, considering that diabetic foot pathology, which is characterized by intrinsic muscle atrophy, can result in a motor imbalance and diffuse claw–toe. This pathology affects both the foot function and postural stability [2].

In diabetic patients, the strength of flexor and extensor muscles at the elbow, wrist, knee, and ankle have been evaluated clinically using manual muscle testing (MMT) and isokinetic dynamometry [3], [4]. The volume of ankle dorsal and plantar flexors, and intrinsic muscle atrophy of the foot have been investigated radiologically using magnetic resonance imaging (MRI) [2], [5]. In contrast to the measurement of the strength of the lower extremity muscles; hand grip strength has seldom been studied in patients with diabetes mellitus (DM) [6]. In the present study, our aims were to establish, using a Jamar dynamometer and a pinch gauge, whether the grip and pinch power of the hand in patients with DM were different than those of healthy non-diabetic control subjects.

Section snippets

Patients and methods

Seventy-six patients with T2DM (mean age: 50.11 ± 7.6 years) were recruited from outpatient clinics of the Department of Internal Medicine, at Kahramanmaras Sutcu Imam University. Forty-seven healthy volunteers (mean age: 46.93 ± 10.2) without diabetes, established by an oral glucose tolerance test (OGTT), served as the control group.

DM was diagnosed according to American Diabetes Association (ADA) diagnostic criteria as follows: a fasting plasma glucose ≥7.0 mmol/L or 2-h plasma glucose ≥11.1 mmol/L

Results

The characteristics and body composition values of the subjects were given in Table 1, Table 2. There were no significant difference between the groups with respect to age, sex, hypertension, proteinuria, and smoking (p > 0.05). However HbA1c values in diabetic patients were significantly higher than those of the control group (7.14 ± 1.64% versus 5.16 ± 0.62%, p < 0.001) (Table 1). BMI, G/H, BF, BMR, and fat mass were similar in both groups (Table 2).

Working status of subjects is given in Fig. 1. All

Discussion

It is well known that mild distal muscle weakness can accompany predominant distal symmetrical sensory neuropathy in DM patients [9]. While there are numerous quantitative studies on sensory neuropathy and autonomic disturbances, there is little data about motor function in diabetic patients [10], [11]. Dyck et al. [3] indicated that clinically apparent muscle weakness was a severe disturbance in type 1 diabetes (T1DM) patients with more advanced neuropathy. However, neither the severity nor

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View full text

Hand grip strength in patients with type 2 diabetes mellitus

Abstract

Aim

Methods

Results

Conclusion

Introduction

Section snippets

Patients and methods

Results

Discussion

Diabetes Res. Clin. Pract.

J. Hand Surg.

Diabetes Res. Clin. Pract.

Arch. Phys. Med. Rehabil.

J. Hand. Surg.

J. Hand Surg.

J. Hand Surg.

J. Biomech.

J. Hand Surg.

J. Hand Surg.

Diabetes mellitus

Intrinsic muscle atrophy and toe deformity in the diabetic neuropathic foot: a magnetic resonance imaging study

Diabetes Care

The prevalence by staged severity of various types of diabetic neuropathy, retinopathy, and nephropathy in a population-based cohort: the Rochester diabetic neuropathy study

Neurology

Isokinetic muscle strength in long-term IDDM patients in relation to diabetic complications

Diabetes

Muscular atrophy in diabetic neuropathy: a stereological magnetic resonance imaging study

Diabetologia

Diabetic and hypoglycemic neuropathy