O que significa “Mão Diabética” e qual o papel da Saúde Ocupacional?

Abstract

Introduction / background / objective As the workforce ages and rates of metabolic diseases increase, it is likely that more cases of “diabetic hand” manifestations will appear in Occupational Health services. While some health professionals know how to quickly track the “diabetic foot”, the “diabetic hand” is often undervalued, diagnosed in isolation, without recognition or association with the high prevalence of metabolic syndrome, especially in the Western world. These manifestations have an impact on functionality, and inevitably affect work performance, and should be subject to screening, monitoring and intervention by occupational health teams, in order to enhance the function and minimize the negative impacts that they cause both individually and collectively. Thus, the main objective of this work is to elaborate a review on the concept of “diabetic hand” and what is the implication that it can have in the worker’s health and Occupational Health practice. Methodology It is a Scoping Review, initiated through a search in the PUBMED (Medline), EBSCO (Cinahl; Medline; Cochrane; Library Information Science & Technology Abstracts; Nursing Allied Health Collection; MedicLatina) and RCAAP databases, conducted in the months of July and August of 2020, covering all articles (in Portuguese and English languages), with no limit of time, that could explain the concept of diabetic hand. The search words used were: “diabetic hand” ou “cheiroarthropathy”. Results Several conditions have been linked to the concept of diabetic hand, namely cheiroarthropathy (limited joint mobility and stiffness), Dupuytren’s contracture, trigger finger (flexor stenosing tenosynovitis), and carpal tunnel syndrome. Conclusions These manifestations share mechanisms with the classic complications of diabetes, and the recognition that microvascular changes occur concomitantly may provide insights for early screening of metabolic biomarkers. Acknowledging so can contribute to reduce disability (delay hand and fist related manifestations’ progression), and also to reduce future morbidity of workers (minimizing the risks of metabolic diseases), helping to maintain a more capable and productive workforce, where corrective measures and early treatments can be implemented. The diabetic hand may be a concept of interest, then can be further addressed soon, as the complications of metabolic syndrome (and associated comorbidities) increase worldwide.