Occurrence of Undiagnosed Diabetes Mellitus With Musculoskeletal Disorders of the Upper Extremity: Prospective Screening With Point‐of‐Care Haemoglobin A1c Fingerstick Testing
Prospective study finds high rates of undiagnosed prediabetes in upper extremity clinic patients, highlighting an opportunity for early metabolic intervention.
Key Points
To determine the viability of point-of-care HbA1c fingerstick screening for undiagnosed diabetes and prediabetes in patients presenting to an orthopaedic hand clinic.
Prospectively enrolled N=84 patients (60.7% female, 60.0% White) diagnosed with carpal tunnel syndrome, trigger finger, Dupuytren's contracture, or De Quervain's disease.
Performed point-of-care HbA1c fingerstick testing and compared demographics and clinical characteristics between normal (HbA1c < 5.7) and elevated (HbA1c ≥ 5.7) cohorts.
HbA1c was elevated in the prediabetes range for 58.3% of patients and in the type 2 diabetes mellitus range for 4.8%, with 62.1% of trigger finger cases having elevated HbA1c.
Patients with elevated HbA1c were significantly more likely to be female (p = 0.008) and present with unilateral symptoms (p = 0.03).
Among patients with prediabetes or diabetes-range HbA1c, 43.4% did not have an established primary care provider.