Self-assessment and objective determination of dexterity in patients with type 1 or type 2 diabetes mellitus

Abstract

Objective:

Insulin-treated patients perform complex treatment activities during daily routine, such as blood glucose measurements and insulin injections. We aimed to identify suitable dexterity and cognitive function tests for diabetes patients, and to compare the patient self-assessment of their dexterity skills with the test results (Jebsen–Taylor hand function test, (JHFT), motoric performance test (MLS), number connection test).

Method:

We enrolled 90 diabetes patients (36 females, 54 males): 15 type 1 with clinically suspected dexterity impairment (A: age: 60 ± 9 years), 30 type 2 with clinically suspected dexterity impairment (B: 61 ± 10 years), 30 type 1 or type 2 patients with visual impairment (C: 64 ± 6 years), and 15 type 1 or type 2 patients without obvious impairment (control group: D: 64 ± 5 years).

Results:

There were no differences regarding neuropathy and slight impairments in the number connection test in all groups. Patient self-assessment revealed that 33.4% in group A, 33.3% in group B, 36.7% in group C and 13.7% in group D, considered themselves to have dexterity impairment. However in the JHFT test, all patients from A (100%) and B (100%), 33% from C, and 0% from D presented with dexterity impairment by only passing less than four subtests.

Conclusions:

Impairment of dexterity was much more frequent than believed by the patients themselves. It may be worthwhile to consider these findings when classifying patients regarding their capabilities to perform certain treatments or when assessing diabetes technology with human subjects.

Key words::

• Dexterity
• Diabetes mellitus
• Diabetes technology
• Jebsen
• Taylor hand function test

Transparency

Declaration of funding

This study was funded by a grant from NovoNordisk, Søborg, Denmark. The sponsor was involved in the planning of the experiment, the discussion of the results and contributed to the manuscript preparation

Declaration of financial/other interest

A.P. and T.F. have disclosed that they have received study grants, speaker fees and travel support from NovoNordisk. M.Q. and M.N. have disclosed that they are employees of NovoNordisk. P.M., C.S. and A.L. have no relevant financial relationships to disclose. CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

The manuscript preparation was supported by Julia Heise and Volkmar Schmid from the IKFE-CRO Medical Writing Team. We would also like to thank the patients, physicians and nurses at IKFE clinic, who were involved in the conduct of the study.

Previously presented as abstract/poster: Annual Meeting of the American Diabetes Association, San Diego, June 2011; and Diabetes Technology Meeting, San Francisco, October 2011