Frequency of Diabetic Cheiroarthropathy among Patients at Atbara Teaching Hospital, Sudan (June–August 2024): A Cross-Sectional Study

Mohammad Osman¹, Ammar Alsuni², Ziryab Mahmoud³, Marwa Alamin⁴, Malaz Alamin⁵, Razan Khider⁶

Abstract

Objective: Diabetic neuroarthropathy (DCA), or limited joint mobility (LJM) syndrome, is an overlooked complication of diabetes mellitus, characterized by hand joint stiffness, skin thickening, and functional impairment. This study aimed to determine the prevalence of DCA among diabetic patients at Atbara Teaching Hospital, Sudan, and evaluate its associations with diabetes duration, glycemic control, and microvascular complications.  

Aim: This study sought to address: 1. Prevalence – How standard is DCA among diabetic patients? 2. Diabetes Duration – Is there an association between DCA and the duration of diabetes? 3. Glycemic Control – What role do HbA1c levels play in DCA development? 4. Microvascular Complications – Does DCA correlate with nephropathy, neuropathy, or retinopathy? 

Methods: A cross-sectional study (June–August 2024) included 160 diabetic patients, excluding those with confounding conditions (hand trauma, arthritis, liver disease). Data were collected via structured questionnaires and clinical examinations, diagnosing DCA based on joint mobility, skin thickening, and positive prayer/tabletop signs. Hemoglobin A1c levels assessed glycemic control, and neuropathy, retinopathy, and albuminuria were also evaluated. Statistical analysis included Chi-square tests and multivariate logistic regression (p < 0.05).

Results: DCA prevalence was 46% (73/160). Patients with HbA1c >7% had a higher DCA prevalence (56% vs. 30%, p = 0.002). Limited joint mobility indicators were more common in poorly controlled patients (prayer sign: 55% vs. 30%, p = 0.002; tabletop sign: 54% vs. 28%, p = 0.001). Diabetes duration was the strongest predictor of DCA (OR 3.29 for 10–20 years, OR 6.52 for >20 years, p < 0.01). Albuminuria showed a non-significant association with DCA (OR 2.82, p = 0.066).

Conclusion:

DCA is highly prevalent (46%) among diabetic patients in Sudan. Longer diabetes duration was the most significant risk factor, reinforcing the impact of chronic hyperglycemia on connective tissues. Poor glycemic control correlated with more severe DCA, but its independent effect was unclear. Early screening, glycemic control, and routine hand function assessments are recommended due to their potential association with microvascular complications.