The prevalence and possible prognostic importance of arthropathy in childhood diabetes.

Specifically defined arthropathy was studied in 95 children with insulin-dependent diabetes mellitus. Thirty-eight patients (40%) had limited joint mobility (p = less than 0.001 vs healthy controls). Children with the following extraarticular findings were more likely to have arthropathy: tight skin of the hands (p = less than 0.001), retinopathy (p = less than 0.05), and/or decreased deep tendon reflexes (p = less than 0.01). When the frequency of articular findings was analyzed as a function of disease duration, a nearly linear increase in the percentage of children having joint findings was evident: 0-3 years, 28%, 4-8 years, 41%: greater than 8 years, 67%. The percentage of patients positive for any microvascular complication during these intervals rose much less sharply: 4-11%, 4-15%, and 24-52%. Since the fraction of children without any joint abnormality constantly decreases, the finding of arthropathy has little value beyond knowledge of disease duration as a predictor of the development of microvascular complications.