{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T22:57:20Z","timestamp":1766012240431,"version":"3.46.0"},"reference-count":46,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,10,4]]},"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate whether a temporal relationship is present between clinical visits for diabetes-related hand syndromes (DHSs) and subsequent type 2 diabetes mellitus (T2DM) diagnosis and, accordingly, whether DHSs can be used for identifying patients with undiagnosed T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This study had a case\u2013control design nested within a cohort of 1 million people from the general population, which was followed from 2005 to 2010. The odds of prior clinical visits for DHSs, namely carpal tunnel syndrome (CTS), flexor tenosynovitis, limited joint mobility and Dupuytren's disease, were estimated for cases and controls. We used a conditional logistic regression model to estimate the OR and 95% CI of T2DM in association with a history of DHSs. The validity and predictive value of using the history of DHSs in predicting T2DM diagnosis were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Taiwan National Health Insurance medical claims.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We identified 33\u2005571 patients receiving a new diagnosis of T2DM (cases) between 2005 and 2010. Each T2DM case was matched with 5 controls who had the same sex and birth year and were alive on the date of T2DM diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome measure was T2DM diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The OR of T2DM in association with prior clinical visits was significantly increased for overall DHS and CTS, being 1.15 (95% CI 1.10 to 1.20) and 1.22 (95% CI 1.16 to 1.29), respectively. Moreover, 11% of patients with T2DM made clinical visits for CTS within 3\u2005months prior to T2DM diagnosis. The history of DHSs had low sensitivity (&lt;0.1% to 5.2%) and a positive predictive value (9.9% to 11.7%) in predicting T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite the unsatisfactory validity and performance of DHSs as a clinical tool for detecting patients with undiagnosed T2DM, this study provided evidence that clinical visits for DHSs, particularly for CTS, can be a sign of undiagnosed T2DM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-012071","type":"journal-article","created":{"date-parts":[[2016,10,20]],"date-time":"2016-10-20T22:39:51Z","timestamp":1477003191000},"page":"e012071","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Medical claims-based case\u2013control study of temporal relationship between clinical visits for hand syndromes and subsequent diabetes diagnosis: implications for identifying patients with undiagnosed type 2 diabetes mellitus"],"prefix":"10.1136","volume":"6","author":[{"given":"Wen-Hsuan","family":"Hou","sequence":"first","affiliation":[{"name":"Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan"},{"name":"Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan"},{"name":"School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan"},{"name":"Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chung-Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan"},{"name":"Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu-Hsuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan"},{"name":"Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang-Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Chieh","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken N","family":"Kuo","sequence":"additional","affiliation":[{"name":"Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiu-Nien","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang-Ta","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Tainan Municipal An-Nan Hospital, China Medical University, Tainan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,10,20]]},"reference":[{"key":"2025120520341478000_6.10.e012071.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2009.10.007"},{"key":"2025120520341478000_6.10.e012071.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2013.11.002"},{"key":"2025120520341478000_6.10.e012071.3","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-s064"},{"key":"2025120520341478000_6.10.e012071.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-011-2331-1"},{"key":"2025120520341478000_6.10.e012071.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0149-2918(03)80122-4"},{"key":"2025120520341478000_6.10.e012071.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2013.11.001"},{"key":"2025120520341478000_6.10.e012071.7","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.6.1480"},{"key":"2025120520341478000_6.10.e012071.8","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.16.1.157"},{"key":"2025120520341478000_6.10.e012071.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(88)80145-X"},{"key":"2025120520341478000_6.10.e012071.10","doi-asserted-by":"publisher","DOI":"10.1016\/0891-6632(89)90016-0"},{"key":"2025120520341478000_6.10.e012071.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-7681(96)80106-9"},{"key":"2025120520341478000_6.10.e012071.12","first-page":"306","article-title":"[The diabetic hand\u2014complications of diabetes]","volume":"98","author":"Lekholm","year":"2001","journal-title":"Lakartidningen"},{"key":"2025120520341478000_6.10.e012071.13","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.mporth.2010.03.016","article-title":"Hand infections","volume":"24","author":"Thornton","year":"2010","journal-title":"Orthop Trauma"},{"key":"2025120520341478000_6.10.e012071.14","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.jdiacomp.2008.12.009","article-title":"The diabetic hand: a forgotten complication?","volume":"24","author":"Papanas","year":"2010","journal-title":"J Diabet Complications"},{"key":"2025120520341478000_6.10.e012071.15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1993.tb00729.x"},{"key":"2025120520341478000_6.10.e012071.16","doi-asserted-by":"crossref","first-page":"99","DOI":"10.3810\/pgm.1999.02.536","article-title":"Limited joint mobility in diabetes","volume":"105","author":"Aljahlan","year":"1999","journal-title":"Postgrad Med"},{"key":"2025120520341478000_6.10.e012071.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(05)80068-1"},{"key":"2025120520341478000_6.10.e012071.18","doi-asserted-by":"publisher","DOI":"10.1016\/S1056-8727(96)00076-1"},{"key":"2025120520341478000_6.10.e012071.19","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/j.1464-5491.1989.tb01137.x","article-title":"Hand abnormalities are associated with the complications of diabetes in type 2 diabetes","volume":"6","author":"Jennings","year":"1989","journal-title":"Diabet Med"},{"key":"2025120520341478000_6.10.e012071.20","first-page":"153","article-title":"Dupuytren's disease: association with chronic diabetic complications","volume":"24","author":"Arkkila","year":"1997","journal-title":"J Rheumatol"},{"key":"2025120520341478000_6.10.e012071.21","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jns.2008.11.006","article-title":"Association between asymptomatic median mononeuropathy and diabetic polyneuropathy severity in patients with diabetes mellitus","volume":"278","author":"Stamboulis","year":"2009","journal-title":"J Neurol Sci"},{"key":"2025120520341478000_6.10.e012071.22","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-200203000-00007"},{"key":"2025120520341478000_6.10.e012071.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2011.07.012"},{"key":"2025120520341478000_6.10.e012071.24","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.22.1.77"},{"key":"2025120520341478000_6.10.e012071.25","unstructured":"Ministry of Health and Welfare. Main indicators of statistics and surveys. 2015. http:\/\/www.nhi.gov.tw\/English\/webdata\/webdata.aspx?menu=11&menu_id=296&webdata_id=1942&WD_ID=296 (accessed 2 Aug 2016)."},{"key":"2025120520341478000_6.10.e012071.26","unstructured":"Insurance BoNH. Regulations governing contracting and management of National Health Insurance medical care institutions. 2014. http:\/\/www.nhi.gov.tw\/English\/webdata\/webdata.aspx?menu=11&menu_id=295&WD_ID=295&webdata_id=2440 (accessed 25 Jul 2015)."},{"key":"2025120520341478000_6.10.e012071.27","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1093\/oxfordjournals.aje.a113439","article-title":"On the need for the rare disease assumption in case-control studies","volume":"116","author":"Greenland","year":"1982","journal-title":"Am J Epidemiol"},{"key":"2025120520341478000_6.10.e012071.28","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-1343"},{"key":"2025120520341478000_6.10.e012071.29","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-1072"},{"key":"2025120520341478000_6.10.e012071.30","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23641"},{"key":"2025120520341478000_6.10.e012071.31","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2012-101287"},{"key":"2025120520341478000_6.10.e012071.32","doi-asserted-by":"publisher","DOI":"10.1002\/art.24740"},{"key":"2025120520341478000_6.10.e012071.33","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2013-101973"},{"key":"2025120520341478000_6.10.e012071.34","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-0361.2005.tb00110.x"},{"key":"2025120520341478000_6.10.e012071.35","unstructured":"Gordis L . More on causal inferences: bias, confounding, and interaction. In: Epidemiology. 2nd edn. Philadelphia: W.B. Saunders, 2000:204\u201321."},{"key":"2025120520341478000_6.10.e012071.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2012.09.014"},{"key":"2025120520341478000_6.10.e012071.37","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.3.565"},{"key":"2025120520341478000_6.10.e012071.38","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1007\/s00063-010-1024-8","article-title":"Carpal tunnel syndrome in diabetes mellitus","volume":"105","author":"Bahrmann","year":"2010","journal-title":"Med Klin (Munich)"},{"key":"2025120520341478000_6.10.e012071.39","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2011.113"},{"key":"2025120520341478000_6.10.e012071.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2010.09.008"},{"key":"2025120520341478000_6.10.e012071.41","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.52.3.812"},{"key":"2025120520341478000_6.10.e012071.42","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2008.11.018"},{"key":"2025120520341478000_6.10.e012071.43","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1471-2342-12-15","article-title":"Ultrasonographic assessment of carpal tunnel syndrome of mild and moderate severity in diabetic patients by using an 8-point measurement of median nerve cross-sectional areas","volume":"12","author":"Chen","year":"2012","journal-title":"BMC Med Imaging"},{"key":"2025120520341478000_6.10.e012071.44","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.apmr.2013.11.017","article-title":"Diagnosis from functional perspectives: usefulness of a manual tactile test for predicting precision pinch performance and disease severity in subjects with carpal tunnel syndrome","volume":"95","author":"Hsu","year":"2014","journal-title":"Arch Phys Med Rehabil"},{"key":"2025120520341478000_6.10.e012071.45","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-119-8-199310150-00011"},{"key":"2025120520341478000_6.10.e012071.46","first-page":"1253","article-title":"Diagnosis and management of depression in primary care: a clinical update and review","volume":"167","author":"Remick","year":"2002","journal-title":"CMAJ"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-012071","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T04:34:23Z","timestamp":1764995663000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-012071"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10]]},"references-count":46,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2016,10,20]]},"published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1136\/bmjopen-2016-012071"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-012071","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2016,10]]}}}