This cross-sectional study aimed to quantify the somatosensory dysfunction in the hand in people with diabetes with distal symmetrical polyneuropathy (DSPN) in hands; and explore early signs of nerve dysfunction in people with diabetes without DSPN in hands. The clinical diagnosis of DSPN was confirmed with electrodiagnosis and corneal confocal microscopy. Thermal and mechanical nerve function in the hand was assessed using Quantitative Sensory Tests. Measurements were compared between healthy participants (n=31), people with diabetes without DSPN (n=35), people with DSPN in feet but not hands (DSPN FEET ONLY; n=31); and people with DSPN in hands and feet (DSPN HANDS & FEET; n=28) using one-way between-group analyses of variance. The somatosensory profile of the hand in people with DSPN HANDS & FEET showed widespread loss of thermal and mechanical detection. This profile in hands is comparable to the profile in the feet of people with DSPN in feet. Remarkably, people with DSPN FEET ONLY already showed a similar profile of widespread loss of nerve function in their hands. People with diabetes without DSPN in feet already had some nerve dysfunction in their hands. These findings suggest that nerve function assessment in hands should become more routine in people with diabetes.

中文翻译：

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手部糖尿病神经病变：一种地方性并发症有待发展？

这项横断面研究旨在量化患有手部远端对称性多发性神经病 (DSPN) 的糖尿病患者手部的体感功能障碍；并探索手无 DSPN 的糖尿病患者神经功能障碍的早期迹象。DSPN的临床诊断通过电诊断和角膜共聚焦显微镜证实。使用定量感官测试评估手部的热和机械神经功能。比较健康参与者 (n=31)、无 DSPN 的糖尿病患者 (n=35)、足部有 DSPN 而非手部的人 (DSPN FEET ONLY；n=31) 的测量值；手和脚部有 DSPN 的人 (DSPN HANDS & FEET; n=28) 使用单向组间方差分析。DSPN HANDS & 患者手部的体感特征 FEET 显示热和机械检测的广泛损失。这种手部轮廓与脚部 DSPN 患者的脚部轮廓相当。值得注意的是，仅患有 DSPN 脚的人已经表现出类似的手部神经功能广泛丧失的特征。足部没有 DSPN 的糖尿病患者手部已经出现了一些神经功能障碍。这些发现表明，手部神经功能评估在糖尿病患者中应该变得更加常规。