Hand pathology in type 1 diabetes mellitus: a case-control study

Purpose This study aims to investigate the factors associated with diabetic hand (DH) in patients with type 1 diabetes mellitus (T1D) using a matched case-control design. Methods A retrospective case-control study was conducted at a tertiary care hospital in Spain. Among a cohort of 968 T1D patients, 45 cases of DH were identified. Cases were matched with 90 controls using propensity score matching based on age, sex, diabetes duration, and presence of retinopathy. Clinical data, comorbidities, and glycemic control (HbA1c and continuous glucose monitoring metrics) were collected. Multivariable conditional logistic regression was used to identify factors associated with DH. Results DH prevalence was 4.6%. Significant associations were found for HbA1c (OR 1.96; 95% CI 1.16–3.28; p = 0.011) and age (OR 1.06; 95% CI 1.01–1.12; p = 0.012). Cardiovascular disease was more common in DH cases (20.2% vs. 2.2%; p = 0.005), but it was not independently associated after adjustment. No significant differences were observed for retinopathy, nephropathy, or other microvascular complications. Conclusions Chronic poor glycemic control, indicated by higher HbA1c, is strongly associated with DH. These findings suggest that DH is a distinct complication of T1D, driven more by hyperglycemia than traditional vascular risk factors. Further research is needed to elucidate pathophysiological mechanisms and therapies.