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Chiropractic Research Review

Limited Joint Mobility Associated with Blood Vessel Disease

Limited joint mobility (LJM) is the earliest clinical complication of diabetes in childhood and adolescence. LJM typically begins in the hands, causing painless limitation of extension of the fifth finger.

This is caused by thickening of the subcutaneous tissue, flexor tendon sheaths, and periarticular skin. LJM affects up to 50% of adult type 1 diabetics, but little is known about possible associations between LJM and vascular disease or gender.

The purpose of this paper was to evaluate the relationship of LJM with early atherosclerosis and gender. A total of 335 type 1 diabetic patients (191 women and 144 men), age 14-40 years, were studied for LJM and findings of vascular disease. Approximately 33% had LJM, which was more prevalent among males (38.9%) than females (29.8%).

Vascular complications of diabetes showed different patterns in women with LJM. Women with LJM were more likely than those without to show some macrovascular complication consisting of cartoid artery thickening between the intima and media layers. Microvascular complications did not differ between women with or without LJM. Men with LJM were about twice as likely as men without LJM to have microvascular diabetic complications, including hypertension, proteinuria (excess protein in the urine) and retinopathy (various noninflammatory disorders of the retina).

Conclusion: LJM is an indicator of microvascular disease in men and early macrovascular disease in women. As the authors note, "LMJ can be clinically assessed with ease and quickness... and physicians should take more care to look for such symptoms, especially in men." Detecting these changes in joint mobility can enable patients to receive early assessment for cardiovascular complications.

Frost D, Beischer W. Limited joint mobility in type 1 diabetic patients. Diabetes Care 2001:24(1), pp. 95-99.

Chiropractic Research Review

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