High HbA1c Linked to Increased Risk of Trigger Finger in Both Type 1 & Type 2 Diabetes

New research from an analysis of a national diabetes register in Europe suggests inadequate glycemic control was linked to an increased risk of developing stenosing tenosynovitis, more commonly known as trigger finger, for people with either type 1 or type 2 diabetes.

An analysis of data from more than 95,000 individuals with diabetes from the Swedish National Diabetes Register, results of the study suggest elevated HbA1c levels were associated with an increase in risk of trigger finger of 26% or more in type 1 diabetes and 12% or more in type 2 diabetes in analyses adjusting for sex, age, duration of diabetes, and other clinical factors.

“In this study, we present evidence that poor glycemic control among individuals with T1D and T2D is associated with development of TF during a study time of 15 years, using high-quality data from Swedish registers. A dose-response relationship was found with increasing risk of TF with increasing HbA1c among individuals with diabetes, also after adjustment for age, duration of diabetes, BMI, smoking, and blood pressure,” wrote investigators.

Covering 90% of individuals with diabetes in Sweden, investigators pulled data from the National Diabetes Register from 2004-2019 to estimate the associations between trigger finger incidence with elevated HbA1c in multivariate logistic regression models. Using the aforementioned time frame, investigators identified information related to 87,555 individuals with type 2 diabetes and 9682 individuals with type 1 diabetes.

From the register, investigators obtained data related to clinical characteristics such as duration of diabetes, medications, laboratory values such as HbA1c and blood lipid levels, blood pressure examinations, BMI, and complications. Investigators pointed out these individuals’ laboratory and anthropometric values, blood pressure, and BMI were measured at least once per year most often in a primary care setting.

Among those with type 1 diabetes, 4304 were women and 5378 were men. Among those with type 2 diabetes, 36,264 were women and 49,491 were men. A total of 486 women and 271 with type 1 diabetes along with 1143 women and 1009 men with type 2 diabetes were diagnosed with trigger finger during the study period. Investigators noted the mean HbA1c levels were higher for both men and women who were diagnosed with trigger finger among those with type 1 (P <.01) and type 2 diabetes (P <.01). Investigators also noted both men and women who were diagnosed with trigger had a longer duration of diabetes, which was apparent for both type 1 diabetes (P <.01) and type 2 diabetes (P <.01).

Results of the adjusted analyses indicated elevated HbA1c levels were associated with a 26% increase in likelihood of developing trigger finger among women (OR, 1.26 [95% CI, 1.1-1.4]; P=.001) with type 1 diabetes and a 40% increase in likelihood among their male counterparts (OR, 1.4 [95% CI, 1.2-1.7]; P <.001) with type 1 diabetes. Similar trends were observed among patients with type 2 diabetes, with elevated HbA1c levels associated with a 14% increase in likelihood of developing trigger finger among women (OR, 1.14 [95% CI, 1.2-1.2]; P <.001) with type 2 diabetes and a 12% increase in likelihood for their male counterparts (OR, 1.12 [95% CI, 1.0-1.2]; P=.003) with type 2 diabetes. Further analysis suggested the greatest increase in likelihood for developing trigger finger was observed among men with type 1 diabetes and poor glycemic control, who had a more than 5-fold increase in likelihood compared to those with type 1 diabetes and optimal glycemic control (OR, 5.33 [95% CI, 2.14-13.26]; P <.001).

“Hyperglycemia increases the risk of developing trigger finger among individuals with type 1 diabetes and type 2 diabetes. Optimal treatment of diabetes seems to be of importance for prevention of diabetic hand complications, such as trigger finger,” wrote investigators in their conclusion.

This study, "High HbA1c Levels Are Associated With Development of Trigger Finger in Type 1 and Type 2 Diabetes: An Observational Register-Based Study From Sweden,” was published in Diabetes Care.