Sclerodactyly and Diabetic Complications among Egyptian Adolescent Type 1 Diabetic Patient

Abstract

BACKGROUND: One of the common complications of diabetic patients is sclerodactyly which is considered as a part of limited joint mobility. AIM: To assess sclerodactyly in adolescent type 1 diabetics and to detect its relation to other diabetic complications. METHODS: Sixty-three diabetics and 60 controls were studied. Clinical, laboratory assessment, ultrasonography of the skin, carotid artery intima-media thickness (cIMT) & renal colour duplex were done for all participants. RESULTS: Sclerodactyly was positive in 12 (19%) of diabetics. Patients with sclerodactyly had a significantly thickened skin compared to patients without sclerodactyly and controls, P = 0.0001. Male diabetics had significantly thickened skin (p = 0.0001). Diabetic patients with sclerodactyly had significant higher systolic blood pressure (p = 0.03), cholesterol (p = 0.05) and triglyceride (p = 0.004) and lower HDL-c (p = 0.04). Skin thickness had a significant positive correlation with age of diabetic patients (p = 0.02), waist/height ratio (p = 0.04), glycosylated hemoglobin (p = 0.03), albumin/creatinine ratio (p = 0.03), and cIMT (p = 0.03). CONCLUSION: Ultrasound easily diagnoses sclerodactyly. Diabetic patients had a high prevalence of sclerodactyly with increased macrovascular and microvascular complications. Sclerodactyly may be a marker for diabetic vascular complications. Frequent follow up of diabetic patients for early detection of sclerodactyly in uncontrolled diabetic patients is recommended. It could be an alarming sign for microalbuminuria, hypertension, hyperlipidaemia and atherosclerosis.