As a consequence of the increased glycation of proteins that occurs in long term diabetes the collagen in the ligaments become more rigid, leading to a condition known as limited joint mobility.
Limited joint mobility (LJM), also known as diabetic cheiroarthropathy or diabetic stiff hand syndrome, is a condition that can occur in people with diabetes mellitus. It is characterized by a decreased range of motion and stiffness in multiple joints, particularly in the hands, fingers, and wrists. LJM is more commonly seen in individuals with long-standing, poorly controlled diabetes.
The exact cause of limited joint mobility in diabetes is not fully understood. However, it is believed to be associated with several factors:
- Glycation: In diabetes, persistently elevated blood glucose levels can lead to a process called glycation. Glycation occurs when excess glucose molecules attach to proteins, causing them to become stiff and less flexible. This can affect the connective tissues in and around the joints, leading to reduced mobility.
- Increased Collagen: Diabetes can lead to an overproduction of collagen, a fibrous protein that provides strength and structure to tissues. Excess collagen can accumulate around the joints, causing thickening and tightening of the joint capsules and limiting movement.
- Microvascular Changes: Diabetes can result in microvascular changes, affecting the small blood vessels that supply nutrients and oxygen to the joints. Reduced blood flow to the joints can impair their health and contribute to limited mobility.
The symptoms of limited joint mobility in diabetes may include:
- Difficulty fully straightening or bending the fingers or wrists.
- Stiffness or tightness in the affected joints.
- Inability to perform certain fine motor tasks, such as buttoning clothes or gripping small objects.
- Thickened, waxy, or tight skin over the joints.
- Contractures, where the joint becomes permanently fixed in a bent position.
Prevention and management of limited joint mobility in diabetes involve several approaches:
- Blood Sugar Control: Maintaining good glycemic control through proper diabetes management, including blood sugar monitoring, medication adherence, and healthy lifestyle habits, may help prevent or slow the progression of limited joint mobility.
- Joint Exercises: Regular exercises and stretching can help improve joint flexibility and maintain range of motion. It is important to consult with a healthcare professional or physical therapist for appropriate exercises tailored to individual needs.
- Hand Care: Keeping the hands and skin well-moisturized can help prevent dryness and cracking. Regularly moving and using the hands throughout the day can help maintain joint mobility.
- Medical Intervention: In some cases, when conservative measures are not effective, a healthcare professional may recommend interventions such as hand therapy, splinting, or joint mobilization techniques to improve joint function.