{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:42:34Z","timestamp":1790916154993,"version":"4.1.0"},"reference-count":21,"publisher":"American Diabetes Association","issue":"7","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":2638,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>The development of periarticular thickening of skin on the hands and limited joint mobility (cheiroarthropathy) is associated with diabetes and can lead to significant disability. The objective of this study was to describe the prevalence of cheiroarthropathy in the well-characterized Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications (DCCT\/EDIC) cohort and examine associated risk factors, microvascular complications, and the effect of former DCCT therapy (intensive [INT] vs. conventional [CONV]) on its development.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>This cross-sectional analysis was performed in 1,217 participants (95% of the active cohort) in EDIC years 18\/19 after an average of 24 years of follow-up. Cheiroarthropathy\u2014defined as the presence of any one of the following: adhesive capsulitis, carpal tunnel syndrome, flexor tenosynovitis, Dupuytren's contracture, or a positive prayer sign\u2014was assessed using a targeted medical history and standardized physical examination. A self-administered questionnaire (Disabilities of the Arm, Shoulder and Hand [DASH]) assessed functional disability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Cheiroarthropathy was present in 66% of subjects (64% of the INT group and 68% of the CONV group; P = 0.1640) and was associated with age, sex, diabetes duration, skin intrinsic fluorescence, HbA1c, neuropathy, and retinopathy (P &amp;lt; 0.005 for each). DASH functional disability scores were worse among subjects with cheiroarthropathy (P &amp;lt; 0.0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Cheiroarthropathy is common in people with type 1 diabetes of long duration (\u223c30 years) and is related to longer duration and higher levels of glycemia. Clinicians should include cheiroarthropathy in their routine history and physical examination of patients with type 1 diabetes because it causes clinically significant functional disability.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc13-2361","type":"journal-article","created":{"date-parts":[[2014,4,11]],"date-time":"2014-04-11T06:47:00Z","timestamp":1397198820000},"page":"1863-1869","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":108,"title":["Musculoskeletal Complications in Type 1 Diabetes"],"prefix":"10.2337","volume":"37","author":[{"given":"Mary E.","family":"Larkin","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital Diabetes Research Center, Harvard University, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Barnie","sequence":"additional","affiliation":[{"name":"Mt. Sinai Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara H.","family":"Braffett","sequence":"additional","affiliation":[{"name":"The Biostatistics Center, The George Washington University, Rockville, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia A.","family":"Cleary","sequence":"additional","affiliation":[{"name":"The Biostatistics Center, The George Washington University, Rockville, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Diminick","sequence":"additional","affiliation":[{"name":"The Biostatistics Center, The George Washington University, Rockville, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Harth","sequence":"additional","affiliation":[{"name":"University of Western Ontario, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Gatcomb","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Golden","sequence":"additional","affiliation":[{"name":"Joslin Diabetes Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janie","family":"Lipps","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Endocrinology, & Metabolism, Vanderbilt University, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gayle","family":"Lorenzi","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of California San Diego, La Jolla, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Mahony","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Diabetes Research Center, Harvard University, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Nathan","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Diabetes Research Center, Harvard University, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications Research Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2014,6,12]]},"reference":[{"key":"2022051623095514900_B1","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/S0002-9343(02)01045-8","article-title":"Musculoskeletal disorders of the hand and shoulder in patients with diabetes mellitus","volume":"112","author":"Cagliero","year":"2002","journal-title":"Am J Med"},{"key":"2022051623095514900_B2","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/S0889-8529(05)70335-2","article-title":"Connective tissue and joint disease in diabetes mellitus","volume":"25","author":"Rosenbloom","year":"1996","journal-title":"Endocrinol Metab Clin North Am"},{"key":"2022051623095514900_B3","doi-asserted-by":"crossref","first-page":"132","DOI":"10.2337\/diaclin.19.3.132","article-title":"Musculoskeletal complications of diabetes mellitus","volume":"19","author":"Kim","year":"2001","journal-title":"Clin Diabetes"},{"key":"2022051623095514900_B4","doi-asserted-by":"crossref","first-page":"2766","DOI":"10.3899\/jrheum.090239","article-title":"Hand syndromes associated with diabetes: impairments and obesity predict disability","volume":"36","author":"Redmond","year":"2009","journal-title":"J Rheumatol"},{"key":"2022051623095514900_B5","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.ejim.2009.08.001","article-title":"Upper limb musculoskeletal abnormalities and poor metabolic control in diabetes","volume":"20","author":"Ramchurn","year":"2009","journal-title":"Eur J Intern Med"},{"key":"2022051623095514900_B6","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1097\/TGR.0b013e3181ef3049","article-title":"Common musculoskeletal disorders in older adults with diabetes","volume":"26","author":"Kemmis","year":"2010","journal-title":"Top Geriatr Rehabil"},{"key":"2022051623095514900_B7","doi-asserted-by":"crossref","first-page":"371","DOI":"10.3899\/jrheum.080349","article-title":"Is diabetes associated with shoulder pain or stiffness? 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