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International Journal of Endocrinology
Volume 2018, Article ID 1897058, 5 pages
Research Article

Limited Joint Mobility Progression in Type 1 Diabetes: A 15-Year Follow-Up Study

1Endocrine Unit, Hospital Universitari Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
2Parc Tauli Hospital Universitari, I3PT, Universitat Autònoma, CIBERSAM, Barcelona, Spain
3Rheumatology Section, Hospital Universitari Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
4Institut d’Investigació Biomedical de Bellvitge (IDIBELL), Barcelona, Spain
5Department of Clinical Sciences, University of Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain
6CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain

Correspondence should be addressed to Javier Labad; tac.iluat@dabalj and Eduard Montanya; ude.bu@aynatnom

Received 8 September 2017; Revised 28 December 2017; Accepted 3 January 2018; Published 2 May 2018

Academic Editor: Ilias Migdalis

Copyright © 2018 Javier Labad et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To assess the evolution of joint mobility over a period of 15 years in type 1 diabetic patients and healthy controls and to determine whether microalbuminuria is associated with a different evolution of joint mobility. Methods. Joint mobility of hand and wrist was determined in 63 patients with type 1 diabetes and 63 healthy subjects. Fifteen years later, 37 (58.7%) diabetic patients and 16 (25.4%) healthy subjects were studied again. Joint mobility was assessed with the Prayer sign and by measuring the angle of maximal flexion of the fifth and third metacarpophalangeal (MCP) joints and wrist. Patients with diabetes were visited 2–4 times every year with regular assessment of glycated hemoglobin (HbA1c), urinary albumin excretion (UAE), and ophthalmoscopy. Results. Fifteen years after the initial exam, diabetic patients showed reduced flexion of the fifth MCP joint (82.6 ± 5.8 versus 76.0 ± 6.4 degrees, ) and wrist (75.9 ± 8.1 versus 73.2 ± 7.4 degrees, ) compared to baseline examination. Joint mobility did not change significantly in healthy subjects. Patients with microalbuminuria showed greater reduction in hand joint mobility than diabetic patients with normal UAE or than healthy subjects (). Conclusions. In type 1 diabetic patients, the severity of LJM progresses with time, and the progression is enhanced in patients with microalbuminuria.