COMPARATIVE QUALITATIVE AND QUANTITATIVE
DERMATOGLYPHIC STUDY ON TYPE 1 AND TYPE 2
DIABETES MELLITUS
Thesis submitted in partial fulfillment for the degree of
Doctor of Philosophy in Anatomy
By
A. PERUMAL
Under the guidance of
Dr. K. Y. MANJUNATH
Vinayaka Missions University
(Vinayaka Missions Research Foundation, Deemed University)
Ariyanoor, Salem - 636 308
Tamilnadu, India
MAY – 2016
Dr. K. Y. Manjunath.,M.S., Place: Salem
Professor, Date :
Department of Anatomy,
Annapoorana Medical College,
Salem.
CERTIFICATE
I, Dr. K. Y. Manjunath, certify that the thesis entitled
“Comparative Qualitative and Quantitative Dermatoglyphic
study on Type 1 and Type 2 Diabetes Mellitus” submitted
by Mr. A. Perumal, for the award of the degree of Doctor of
Philosophy in Anatomy is the record of research work
carried out by him during the period January 2011 to April
2016 under my guidance and supervision and that this has
not been formed the basis for the award of any other degree,
diploma, associateship, fellowship or any other similar titles
in this or any other institution of higher learning.
Signature & Official seal of the guide
DECLARATION
I, A. Perumal, declare that the thesis
entitled“Comparative Qualitative and Quantitative
Dermatoglyphic study on Type 1 and Type 2 Diabetes
Mellitus”submitted by me for the award of Doctor of
Philosophy in Anatomyis the record of research work
carried out by me during the period January 2011 to April
2016under the guidance ofDr. K. Y. Manjunathand that has
not formed the basis for the awardof any other degree,
diploma, associateship, fellowship or anyother similar titles in
this or any other institution of higher learning.
Place: Salem Signature of the candidate
Date :
ACKNOWLEDGdEMENTS
It is a great pleasure and privilege to acknowledge those who helped me to complete my thesis, which appeared impossible at the beginning.
I express my sincere thanks to all Type 1, Type 2 Diabetic patients and Normal subjectswithout whose dedicated voluntary contribution my thesis would not have been completed.
I express my sincere and heartfelt gratitude to their tremendous and continuous support and encouragement shown throughout my career to my Mother Mrs. P. Solaiyammal and my Father Mr. K. Ammasai, my wife Mrs. R. Priyadarshini, My daughter P. Monikha, My sister Mrs. A. Seerangammal, brother in-law Mr. T. Dharmalingam, My brother Mr. M. Balasubramanian and my sistersMs. U. Sathya Priya and Ms. M. Ranjitha.
With profound gratitude, I express my sincere thanks to my mentor and esteemed guide, Professor Dr. K. Y. Manjunath.,M.S., Anatomy, Department of Anatomy, AMCH, Salem for his untiring, inspiring, constant, continuous motivation, dedication, persistent guidance and thought provoking suggestions at every stage of this work.
It would be a great pleasure to express my heartfelt sincere thanks to Dr. K.R. Srinivasan.,M.S., Professor, Department of Anatomy and Dr. Mrs. P. Kotiswary., M.D, Professor of Pathology, VMKVMCH, Salem, for their continuous support, appreciation, blessings and encouragement in completion of my thesis.
I express my sincere thanks to our beloved Late Founder Chancellor Dr. A. Shanmughasundaram, Mrs. Annapoorni Shanmughasundaram, Chancellor, Dr. A. S. Ganesan, Vice Chairman, Dato. Dr. S. Sharavanan, Vice Chancellor Professor. Dr. V. R. Rajendran, Registrar Dr. Y. Abraham,Vinayaka Missions Research Foundation and University for their kind permission for completion of this study.
I express my special heartfelt sincere thanks to Research Dean Dr.K. Rajendran, M.A., Ph.D., Vinayaka Missions University , Dean Dr. K. Jayapal M.D.,Dr. P. S. Manoharan, M.S., Medical Superintendent, Dr. G. Kannan, M.D., Deputy Medical superintendent, Dr. R. Rajaram, M. D., Vice Principal, Vinayaka Mission’s Kirupananda Variyar Medical College, Salem, for their kind permission, encouragement, guidance and good support for completion of this study.
I owe my sincere gratitude to Dr. Deepti Shastri, M.S, Professor and Head, Department of Anatomy, for her continuous support, encouragement, help and special permission granted to go to other Diabetic institutions which provided a great opportunity for completing my thesis during my entire research period.
I express my sincere thanks to Dr. A. Anand, M.D, Dr. Shanta Chandrasekaran, M.D, Dr. K.C. Shanthi, M.D,Dr. K. Udaya, M.D,Dr. Sathya, M.D,Dr. M. Gayathri,M.D,Dr. Kavitha, M. Sc, Ph. D,Dr. Rajitha, M. Sc, Ph. D,Dr. Rekha, M. Sc, Ph. D,Mrs. G. Panneerselvi, M. Sc, Department of Anatomy, VMKVMCH, Salem for their constant support and helps rendered.
My sincere thanks to Mrs. Baby Kutty, Mr. Jayakumar, Mr. Liju Mamman, Mrs. Anitha, Mr. Thamarai Kannan, Mr. Chandrakumar, Mrs. Kalaivani, Mrs. Rajalakshmi, Mr. Karthik, Mr. Senthil Kumar, Mr. Ramesh Kumar, Mr. Jagadeesh, Mr. Satheesh Kumar, working in the VMKVMCH laboratory for their continuous support for my entire study period.
I express my sincere thanks to Dr. Arun Prasath., M.D., Assoc. Professor of Anatomy, Annapoorana Medical College and Hospitals for his suggestions and introduction to various Diabetic clinics in Salem.
I express my heartfelt gratitude to Dr. M. G. Yuvaraj, M.B.B.S., Diploma in Diab,Mrs. Rajeswari, Dietitian ,M G diabetes Specialty and Research Centre, Salem, Dr. B. Rajaganesan, MBBS, Diploma in Diab, Mr. B.K. Parthiban, Mrs. P. Amutha, Mrs. A. Maheswari Sushruta Diabetic Care Centre, Salem - 7, Dr. S. Krishna., MBBS, S.K.M Hospital, Edapadi, Mr. Sengootuvelavan. BPT., Physiotheraphy clinic, Edapadi Dr. Hari Janakiraman, M.D., D.N.B (Nephro), Managing Director, Salem Gopi Hospitals Private Limited, Salem, Dr. S. P. Sathish Kumar, M.D., F. Diab., Sagar Diacare Clinic, Salem, for permitting me to do my research work in their Hospitals.
I express my heartfelt and sincere gratitude to Dr. N. Mohan., M.S., Dean, Dr. S.R. Subramanian. M.D., H.O.D of Department of Medicine, Dr. G. Prakash., M.D., Dip. Diab., H. O. D of Dept. of Diabetology, Mrs. R. Arivuchudar., M.Sc., M. Phil., Dietician, Mr. S.A. Shanmugam, M.Sc., dietician, Mohan Kumaramangalam Medical College and Hospital, for granting permission and support to my thesis study in government Hospital.
I also express my heartfelt gratitude to Mr. P. Sivaprasad.,M. Sc., Lecturer of Biochemistry, Annapoorana Medical College, for his valuable advices and statistical analysis of the data.
I sincerely thank all the non teaching staff of Department of Anatomy, V.M.K.V.M.C Mr. I. Jayavel, M. Sc., Mr. Muthusamy, Mr. Periyanna, Mr. Thangamani, Mrs. Chandra, Mrs. Shanthi, Mrs. Sudha, Mrs. Perumayee, Mrs. Lakhsmi and Mrs. Chinnammal.
Finally, I thank the Almighty for answering all my prayers and showering his grace by making all these things possible without any hurdles.
CONTENTS
S. NO TITLE PAGE NO.
1. INTRODUCTION 1 – 23
2. REVIEW OF LITERATURE 24– 46
3. NEED FOR THE STUDY 47
4. OBJECTIVES AND HYPOTHESES 48
5. MATERIALS AND METHODS 49–61
6. RESULTS AND DISCUSSION 62– 123
7. CONCLUSION 124– 126
8. SUMMARY 127– 129
9. BIBLIOGRAPHY 130– 140
10. PUBLICATIONS / ETHICAL CLEARANCE
141 – 145
LIST OF CONTENTS
S. NO. TITLE PAGE NO.
1. INTRODUCTION 1 – 23
1.1. Diabetes mellitus 2 – 3
1.2. Classification of Diabetes mellitus 3
1.2.1. Type 1 Diabetes mellitus 3 – 4
1.2.2. Type 2 Diabetes mellitus 4 – 5
1.3. Dermatoglyphics 6
1.3.1. Dermatoglyphics - Chronology of
Development
6 – 7
1.3.2. Skin and its Characteristics in Relation to
Dermatoglyphics
7 – 8
1.3.3. Epidermal ridges 8
1.3.4. Embryogenesis and Genetics of Epidermal
Ridges
9
1.3.5. Classification of Fingertip Pattern
Configuration
10 – 12
1.3.6. Dermatoglyphic landmarks on the fingertip 13 – 15
1.3.7. Palmar Patten configuration 15
1.3.8. Second, Third and Fourth inter digital areas 15 – 16
1.3.9. Palmar landmarks 16
1.4. Quantitative Analysis 17
1.4.1. Ridge counting 17
1.4.2. Finger ridge counts 17 – 18
1.4.3. Ridge counts of the inter digital areas of the
palms
18 – 19
1.4.4. Palmar angles measurement 19
1.5. Correlation of Dermatoglyphics with Clinical
Conditions
20
1.6. Dermatoglyphics - Present Status 20 – 21
1.7. Dermatoglyphic research in Diabetes
mellitus
22 – 23
2. REVIEW OF LITERATURE 24 – 46
3. NEED FOR THE STUDY 47
4a. OBJECTIVES 48
4b. HYPOTHESIS 48
5. MATERIALS AND METHODS 49 – 61
5.1 Tools 49
5.2. Method 49
5.2.1. Procedure 49
5.3. Study Design 52
5.3.1. Inclusion criteria 53
5.3.2. Exclusion criteria 53
5.4. Parameters observed 54 – 61
5.4.1. Qualitative parameter 54
5.4.1.1. Fingertip patterns 54 – 57
5.4.2. Quantitative Parameters 58 – 61
5.4.2.1. Palmar Angles measurement 58 – 59
5.4.2.2. Second, third and fourth inter digital area
ridge count
60
5.4.2.3. Fingertip ridge count analysis 61
5.5. Statistical analysis 61
6. RESULTS & DISCUSSION 62 –123
6.1. Quantitative dermatoglyphic pattern of Type
1 Diabetic patients
63 – 71
6.2. Qualitative dermatoglyphic pattern of Type 1
Diabetic patients
72 – 82
6.3. Quantitative dermatoglyphic pattern of Type
2 Diabetic patients
82 – 94
6.4. Qualitative dermatoglyphic pattern of Type 2
Diabetic patients
95 – 103
6.5. Quantitative dermatoglyphic pattern of Type
1 with Type 2 Diabetic patients
104 –111
6.6. Qualitative dermatoglyphic pattern of Type 1
with Type 2 Diabetic patients
112 – 123
7. CONCLUSION 124 – 126
8. SUMMARY 127 – 129
9. BIBLIOGRAPHY 130 – 140
10. PUBLICATIONS / ETHICAL CLEARANCE /
PATIENT PROFORMA / CONSENT FORM/
RESEARCH FORM
141 – 145
ABBREVIATIONS
S. NO LIST OF ABBREVIATIONS
1 UL – Ulnar Loop
2 W – Whorl
4 RL – Radial Loop
5 A – Arch
6 TFRC – Total Finger Ridge Count
7 SWCW – Symmetrical Whorl Clock Wise
8 SWACW – Symmetrical Whorl Anti Clock Wise
9 DLW – Double Loop Whorl
10 TUL – Transitional Ulnar Loop
11 TRL – Transitional Radial Loop
12 CPUW – Central Pocketed Ulnar Whorl
13 CPRW – Central Pocketed Radial Whorl
14 LPULW – Lateral Pocketed Ulnar Loop Whorl
15 LPRLW – Lateral Pocketed Radial Loop Whorl
16 TA – Tented Arch
17 ACC.W – Accidental Whorl
18 SPSS – Statistical Package Social Service
19 Type 1 DM – Type 1 Diabetes Mellitus
20 Type 2 DM – Type 2 Diabetes Mellitus
1
1. INTRODUCTION
Diabetes mellitus is a global problem that is still growing in proportion.
Therefore, researchers are looking for new methods for its diagnosis
and treatment.India leads the world with largest number of diabetics
and has earned the distinction of being called the "diabetes capital of
the world".
International Diabetes Federation has reported that in 2013, 382
million people had diabetes worldwide in the age group between
20-79 years and the number is expected to increase to 592 million by
2035. In India, 65.1 million people had diabetes in 2013 and this
number is expected to increase to 109 million by 2035.
Origin ofdiabetes mellitus is multifactorial, such as genetic, metabolic,
and a result of laidback sedentary lifestyle. As heredity is an essential
element as a cause of diabetes, there is a necessityto carry out more
number of quantitative and qualitative dermatoglyphic surveys on
larger population groups.Predicting the onset of diabetes mellitus by
dermatoglyphics will contribute significantly to the decrease in the
morbidity and mortality of diabetes Mellitus.
The present study is focused on the dermatoglyphic features of
diabetes patients. It will be possible to diagnose diabetes by using
2
these characteristics, since dermal characteristics are unique, stable
in foetus and after birth, till the end of life and they are not altered
during the life time due to age except injuries and skin disease. It is
an established scientific fact that no two individuals, including
monozygotic twins, have the same fingerprints and other details of
dermal ridges.From1978numerous studies have been carried out to
link the dermatoglyphics patterns with onset of type 1 and type 2
diabetes mellitus.
1. 1. Diabetes mellitus:
Diabetes mellitus is a common metabolic disorder related to glucose
metabolism. Severaltypes of diabetes mellitus have been defined
andeach type attributed to a complex interaction of genetical and
environmental factors.Causative factors of hyperglycemia includes
reduced insulin secretion, decreased glucose utilization and
increased glucose production depending on the aetiology of the
diabetes mellitus. Diabetes mellitus is the leading cause of end-stage
renal disease, nontraumatic lower extremity amputations and adult
blindness. It also predisposes to cardiovascular diseases. With an
increasing incidence worldwide, diabetes mellitus will be a leading
cause of morbidity and mortality for the foreseeable future.Predicting
the onset of diabetes mellitus by dermatoglyphics will contribute
3
significantly to the decrease in the morbidity and mortality of diabetes
mellitus.
1.2. Classification of Diabetes Mellitus:
The two broad categories of diabetes mellitus are designated as type
1 and type 2. Phase of abnormal glucose homeostasis as the
pathogenic processes progressespreceded both types of diabetes
mellitus.
1.2.1. Type 1 Diabetes mellitus:
Type 1 diabetes mellitus results from autoimmune beta cell
destruction and most but not all individuals have evidence of islet
directed autoimmunity. Individuals with a genetic susceptibility begin
to lose beta cells secondary to autoimmune destruction that occurs
over months to yearshave normal beta cell mass at birth. This
autoimmune process is sustained by a beta cell specific molecule,
thought to be triggered by an infectious or environmental stimulus.
Although normal glucose tolerance is maintained, beta cell mass then
begins to decline and insulin secretion becomes progressively
impaired.
Features of diabetes do not become evident until a majority of beta
cells are destroyed (80%). Individuals with type 1 diabetes
4
mellitustend to have the following characteristics: (1). onset of
disease prior to age 30, (2). lean body habitus, (3). requirement of
insulin as the initial therapy, (4). propensity to develop
ketoacidosisand (5). an increased risk of other autoimmune disorders
such as autoimmune thyroid disease, adrenal insufficiency,
pernicious anaemia, celiac disease and vitiligo.
1.2.2. Type 2Diabetes Mellitus:
Type 2 diabetes mellitus is associated with a strong genetic
component. In identical twins the association of type 2 diabetes
mellitus is between 70 - 90%. The risk approaches 40% if both
parents have type 2 diabetes mellitus or individuals with a parent with
type 2 diabetes mellitus.
Individualswith type 2 diabetes mellitus often exhibit the following
features: (1).develop diabetes after the age of 30, (2). are usually
obese (80% are obese, but elderly individuals may be lean), (3).may
not require insulin therapy initially and (4).may have associated
conditions such as insulin resistance, hypertension, cardiovascular
disease, dyslipidemia or polycystic ovarian syndrome. Although most
individuals diagnosed with type 2 diabetes mellitus are older, the age
5
of diagnosis is declining, and there is a marked increase among
overweight children and adolescents.
1.3. Dermatoglyphics:
Cummins and Midlo (1926)were the firstto coin the term
‘Dermatoglyphics’ (from twoGreek words: derma - skin, glyphe - to
carve). It isthe science and art of the study of
surfacemarkings/patterns of ridges on the skin of the fingers, palms,
toes and soles. Palm is the most accessible part of the body
usingwhich we can easily obtain the dermatoglyphic
prints.Dermatoglyphic analysis is referred as the poor man's
Karyotype. Dermatoglyphic analysis can be employed as a method of
screening for diabetes mellitus in a large population for early
detection of high risk cases.It is aneconomical tool to provide simple,
inexpensive, anatomical and non-invasive criteria of detecting the
association with diseases which have a strong hereditary basis. Thus
reducing the morbidity and mortality.Predictingthe development of
diabetes at a later date,dermatoglyphics can be used as a diagnostic
tool.Thepresent research work results emphasises the above
statement.
6
1.3.1. Dermatoglyphics - Chronology of Development:
The knowledge of dermatoglyphics is thousands of years old as
evident from the stone carvings found at the edge of Kejimkoojik Lake
in Nova Scotia and in the walls of Neolithic burial passages found on
the island of Brittany. The ancient Indian literature also describes
various fingerprintpatterns as Chakra, Shankh and Padma.Ziegler et
al., (1993) state that fingerprints and handprints are widely used in
criminology.Recentlyfingerprints and handprints have been applied to
the field of medical and genetic diagnoses of diabetes mellitus.
Purkinje., (1823)in his scientific study of papillary ridges of the hands
and feet, classified the papillary lines on the fingertips into nine types:
1). Arch, 2). Tented arch, 3). Ulnar loop, 4). Radial loop,
5). Peacock’s eye, 6). Compound spiral whorl, 7). Elliptical whorl,
8). Circular whorl, and 9). Double loop / Composite, was credited as
the beginning. He also found that the finger tippatterns,ridges and
lines begin to form at thirteenth week in the womb.
Galton conducted extensive research in 1892regarding the
significance of skin ridge patterns. Galtondemonstrated permanence
of skin ridge patterns. He emphasized the use of skin ridge patterns
as a means of identification and demonstrated the hereditary
7
significance of fingerprints and biological variations of different finger
print patterns,indifferent racial groups.
Midlo together with others in 1929 published one of the most widely
referred book "Fingerprints, Palms and Soles", a bible in thefield of
dermatoglyphics.
Bonnevie speculated during 1929, fingerprint patterns were
dependent upon the underlying arrangement of peripheral nerves.
Humphrey in 1964 has pointed out that digital and palmar creases are
secondary features, which are related to flexion movements of the
developing hand during the seventh and fourteenth weeks of fetal life.
1.3.2. Skin and itsCharacteristics in Relation
toDermatoglyphics:
The earliest signs of many systemic disorders may be apparent in the
skin. Examination of the skin, therefore, is of importance in the
diagnosis of more than, just skin diseases.
The outer surface of skin consists of various markings some of them
are large and conspicuous and others are microscopic. These
markings are often referred to as skin lines or papillary
ridges.Papillary ridges are confined to the palms and soles and the
8
flexor surfaces of the digits, where they form narrow, parallel or
curved arrays separated by narrow furrows.
1.3.3. Epidermal ridges:
The epidermal ridges are regularly spaced small down growths of
epidermal cells which appear in finger and toe pads during the
second and third months. They are known as primary epidermal
ridges separated by corresponding dermal ridges. In the fifth month
secondary ridges develop the pattern becomes evident on surface
and is finalized through further remodeling postnatally.The epidermal
ridges correspond to an underlying interlocking pattern of dermal
papillae, an arrangement which helps to anchor the two layers firmly
together.
The pattern of dermal papillae determines the early development of
the epidermal ridges. This arrangement is stable throughout life,
unique to the individual and therefore significant as a means of
identification.The analysis of ridge patterns by studying prints of them
is known as dermatoglyphics.
9
1.3.4. Embryogenesis and Genetics of Epidermal Ridges:
The ridge formation begins in the fetus at 70 mm crown rump
lengthwhen the volar pads are at their peak development.At the
beginning stage, the outer surface of the epidermis is remains smooth
and in the fourth month,the basal layer of the epidermis shows
undulations due to epidermal proliferation. This epidermal
proliferationforms distinct, clearly defined folds of the lower layer of
the stratum germinativum which is growing downward into the corium.
The corium forms papillae projecting upward into the epidermis.
These epidermal folds, later perceivable as glandular folds, form in a
lateral - distal to medial - proximal direction on the fingertips. The
center is initially free of folds. Subsequently, more and more folds
form at the periphery of the pads and finally cover the entire pad
surface. The epidermal ridge patterns are under genetic
influence.Galton and Wilder are the first to have studied the
hereditary basis of dermal patterns, which has since been confirmed
by numerous genetic studies.Individual dermatoglyphic traits were
claimed to be inherited as dominant, incompletely dominant,
recessive, single gene or polygenic, with complete or incomplete
penetration and variable expression of the genes.
10
1.3.5. Classification of Fingertip Pattern Configuration:
In 1892, Galton divided the ridge patterns on the distal phalanges of
the fingertips into three groups as arches, loopsand
whorls.Thissimple classification is still recognized. Used by the
majority of investigators today inspite ofavailability of numerous sub-
classifications. These are helpful in the diagnosis of genetic disorders
as well as in forensic medico legal cases for personal identification.
The simplest pattern seen on the fingertips is an arch. Arches are
formed by succession of parallel ridges. These ridges form a
curvewhich isproximallyconcave. Twotypes of archeshave been
identified. Ridges crossing the fingertip from side to side, without
recurving–the plain arch (A).Ridgesmeet at a point so that their
smooth sweep is interruptedis called as the tentedarch (T or A).
When the ridgesare radiating from a point in three different
directionsforming a point of confluence is called as a triradius.
If the tri radius is located near the midline axis of the distal phalanx it
is called the tented arch. The distal radiant of the tri radius is directed
vertically toward the apex of the fingertip. A tent like patternformed by
ridges passing over this radiant is called the tented arch. Although the
distal radiant usually terminates after only a short vertical course, it
may occasionally re-curve sharply and point laterally or
11
proximally.Such arches may simulate a loop or even a much reduced
whorl, as illustrated by Cummins and Midlo (1961).
Themost common pattern of the fingertip is aloop. Recurving
abruptly,a series of ridges enter the pattern area on one side of the
digit and leaves the pattern area on the same side of the digit.
Theloop is known as ulnar loop (Lu),if the ridge opens on the ulnar
side.The radial loop (Lr) is the one which opens towards the radial
margin.A loop has a single tri radius or confluence point or ridges.
The tri radius is usually located laterally on the fingertip and always
on the side where the loop is closed. Their size can be measured by
counting the ridges.
Any ridge configuration with two or more triradii is known as a whorl,
with one tri-radiuseach on the radial side and ulnar sides. Henry.,
(1937) identifiedthose configurations having ridges that actually
encircle a core as whorl. The ridges with a succession of concentric
whorls are known assimple whorls.
A pattern is called a spiral whorl consists of spirals around the core in
either a clockwise or a counterclockwise directions.Sometimes, both
circles and ellipses or circles and spirals are present in the same
pattern, so that, for example, a whorl that is concentric near the
12
corebecomes a spiral towards the periphery of the pattern, the size of
the whorl can vary considerably.
A loop pattern within which a smaller whorl is located is known
ascentral pocket whorl (Wcp).Accordingto the side on which the outer
loops open the central pockets are classified as ulnar or radial.
Another type is composed of interlocking loops, which may form
either a lateral pocket (Wlp) or a twin loop (Wtl) pattern. Each has two
tri radii and the two types of whorls are morphologically similar.
However, in a twin loop whorl, the ridges emanating from each core
open toward the opposite margin of the finger and the pattern cannot
be designated as either ulnar or radial. In a lateral pocket loop whorl
both ridges emanating from the core emerge on the same side of the
pattern. The pattern can be described as a radial or ulnar subtype.
The significance of separating these two varieties of loop whorls, for
medical diagnosis remains unproved and therefore, they are
ordinarily grouped together as a double loop (Wdl).
The accidentals (Wacc) are the complex patterns which cannot be
classified as one of the above patterns.A loop and a whorl, triple
loops and other unusual formations with a combination of two or more
configuration are called as the accidentals.
13
1.3.6. Dermatoglyphic Landmarkson the Fingertip:
Triradii, cores and radiantsare the three basic dermatoglyphic
landmarks found on the fingertip patterns.
A triradiusis theconfluence of three ridge systems.Thetriradial point is
the centre of the triradius. Themeeting point of three ridges that forms
angles of approximately 120 degree with one another is called as the
triradial point.
However, if the three ridges fail to meet, the triradial point can be
represented by a very short, dot like ridge called an island or by a
ridge ending or it may lie on a ridge at the point nearest the centre of
the divergence of the three innermost ridges. Sometimes, the triradial
point does not lie on a ridge and is determined as the point where the
three angles between the innermost ridges are each as near as
possible to 120 degree. The line along which ridges are counted, the
triradial point forms one terminus.
Inridge counting, a core which is in the approximate center of the
pattern is the important landmark considered. The core can be of
different shapes:In a loop, the core is formed by a straight, rod like
ridge or a series of two or more such parallel ridges. In the center of
the loop, the innermost ridge is called as a core if a straight ridge is
14
absent. In a whorl, the core can appear as a dot or a short ridge or it
can be a circle or an ellipse. In ridge counting, not the whole core but
the point of core only is used. The point of core is at the distal tip of
the straight line forming the core. When the innermost recurving ridge
contains no ending ridge, the point of core is placed on the shoulder
of the loop farther from the triradial point. The shoulders of a loop are
the points at which the recurving ridge definitely curves. When an
even number of rod like ridges is present, the point of core is placed
on the end of one of the two center ridges farther from the digital
triradius. If there are two straight ridges within the innermost recurving
ridge, one of which does not rise as high as the shoulder of the loop,
the tip of the other ridge is chosen as the point of core. When an
uneven number of rods make up the middle of the pattern, the point
of core is the tip of the central rod like ridge. The recurving ridge
representing the core must have no appendage connected
perpendicularly to its tip on the outside. In the presence of such an
appendage, the loop is considered spoiled and the next loop outside
is considered in locating the point of core. Two recurving ridges side
by side at the centre of the pattern are treated as one loop with two
rods within the recurve. The rod farther from the triradius is chosen as
carrying the point of core.
15
The radiants are ridges that originate from the triradius and enclose
the pattern area. These ridges are the skeletal framework of the
pattern area. In schematic drawings, the type lines alone are used to
represent the pattern. By following the ridges that originate in the
triradius, the type lines can easily be traced. If a traced ridge forming
a type line is interrupted, the tracing is made through the interruption.
If there is no direct continuation of the ridge, the tracing is continued
on an adjacent ridge farther from the interior of the pattern area. If the
traced ridge is bifurcated, the tracing is followed on the peripheral
branch of the fork.
1.3.7. Palmar Patten Configuration:
Thepalm has been divided into several anatomically defined areas,in
order to carry out dermatoglyphic analyses.The areas approximate
the sites of embryonic volar padsand include the thenar area, four
inter digital areas and the hypo-thenar area.
1.3.8. Second, Third and Fourth Inter Digital Areas:
These areas are found in the distal palm in the region of the heads of
the metacarpal bones. Each inter digital area is bordered laterally by
digital triradii. The digital triradii are almost always located proximal to
the base of digits II -V. Digital tri radii are labeled a, b, c and d,
16
starting from the triradius associated with digit II. The second inter
digital area (I2) lies between triradii a and b, the third inter digital area
(I3) between triradii b and c and the fourth inter digital area (I4)
between triradii c and d. If a digital triradius is absent, the midpoint of
the base of the corresponding digit can be used to separate inter
digital areas.
1.3.9. Palmar Landmarks:
The digital and axial triradii and the main line traced from each,
constituted important landmarks for dermatoglyphic analysis. Digital
triradii were mentioned earlier in connection with inter digital areas.
Typically, there are four digital triradii in the distal portion of the palm.
They are found in the metacarpal region at the base of digits II, III, IV
and V. Each triradius is normally associated with one digit. By
convention, they are termed a, b, c, and d, proceeding in a
radio - ulnar direction. The triradius or triradii close to the palmar axis
are termed axial triradii (t). Symbols t, t', t'' are used to designate the
position of these triradii in the proximal - distal direction on the palm.
17
1.4. Quantitative Analysis:
By counting the number of triradii or ridges within a pattern and
measuring distances or angles between specified points, many
dermatoglyphic characteristics can be described quantitatively.
1.4.1. Ridge counting:
Ridge counting is used to indicate the pattern size.It is primarily
utilized on fingertips and toes as a way of expressing the distance
between digital triradii or the ridge density in a given area.
1.4.2. Finger ridge counts:
The finger ridge count is carried out along a straight line connecting
the triradial end tothe core. The points excluded from the finger ridge
count are, a).Thepoint of core and b). The triradial point. Otherwise,
every ridge crossing the line is counted, including a ridge that
terminates just after crossing the line.However, a ridge terminating
just before touching the line is not counted. If the ridge bifurcates
before or on meeting the line, the two ridges are counted. Interstitial
lines are not counted.
Whorls that possess two triradii and at least one point of core allow
two different counts to be made, one from each triradius. Each count
is made along a line drawn between the triradial point and the nearest
18
point of core.The rule to be observed is that the straight lines used for
counting the ridges must not cross one another. They should be
chosen, so that they both cross the ridged areas as nearly as
possible at right angles. The two counts can be specified as radial
and ulnar counts. It must be remembered that a radial loop has an
ulnar triradius from which the count is made, where as an ulnar loop
has a radial count. When both counts are given, the first is the radial
count and the second is the ulnar count. A total finger ridge count
(TFRC) represents the sum of the ridge counts of all ten fingers,
when only the larger count is used on ten digits withmore than one
ridge count.
1.4.3. Ridge Counts of the Inter Digital Areas of the
Palms:
Betweentwo digital triradii in the inter digital areas of the palms,
ridges are often counted. The ridge count is most frequently obtained
between triradii a and b. It is referred to as the a-b ridge count.
Counting is carried out along a straight line connecting both triradial
points. The count excludes the ridges forming the triradii. Otherwise,
the counting is done according to the same principles as applied in
ridge counting on the digits. Counting ridges between b and c and
between c and d triradii is sometimes difficult because of the direction
19
of some ridges forming inter digital patterns. These ridges may lie
almost parallel, instead of perpendicular to the line of counting and
are therefore not crossed by the line between triradii. The b-c and c-d
ridge counts are rarely used in dermatoglyphic analysis for medical
purpose.
1.4.4. Palmar Angles Measurement:
atd angle:The most commonly used method is the atd angle. The atd
angle is constructed by lines drawn from the digital triradius "a" to the
axial triradius "t" and from this triradius to the digital triradius "d". The
atd angle is larger when the position of "t"is more distal.
dat angle: This angle is constructed by lines drawn from the digital
triradius "d" to the digital triradius "a" and from this triradius to the
axial triradius "t".
tda angle: This angle is formed by lines drawn from the axial triradius
"t" to digital triradius ''d'' and from this triradius to the digital triradius
"a".
The angles atd, tda, and dat are measured on the palm, using the
most proximal "t" triradius present on the palm.
20
1.5. Correlation of Dermatoglyphics with Clinical
Conditions:
Schaumann and Alter., (1976) have published a book
"Dermatoglyphics in medical disorders" which summarizes the
findings of dermatoglyphic patterns in various disease conditions.
After having basic knowledge of dermatoglyphics, researchers were
inspired to search and investigate its correlation with various types of
afflictions like psychological, physiological, neurological depression,
epilepsy, schizophrenia, dementia, neurofibromatosis, dental caries,
mongolion idiocy, psoriasis, the numerical and structural aberrations.
The features of dermatoglyphics are most important in the medico
legal cases of disputes of paternity. It has a very crucial role in
monozygotic and dizygotic twin's studies.
1.6. Dermatoglyphics - Present Status:
The current state of medical dermatoglyphics helps in the diagnosis
of several dermatoglyphic features with which researches claim a
very high degree of accuracy in their prognostic ability from the hand
features.
Onthe significance of skin ridge patterns,over the last thirty
years,more thanfour thousandpapers had been
21
written.Dermatoglyphic analysis is now beginning to prove itself as an
extremely useful tool for preliminary investigations in conditions with a
suspected genetic basis.Themain thrust of scientific dermatoglyphic
research has been directed ingenetic research and the diagnosis of
chromosomal defectsin the latter half of the twentieth century.
Fromthe patterns of the hand thediagnosis of disease will become a
quite ordinary and commonplace activity. Dermatoglyphic analysis
has gained an integral part of the medical syllabusin Germany.
Thehand is recognised as a powerful tool in the diagnosis of
psychological, medical and genetic conditionsthrough decades of
scientific research.
The utility of dermatoglyphics does not lie indiagnosing the disease,
but to predict the outcome of disease and also the recognition of
people with genetic predisposition to develop
diseases.Dermatoglyphics is useful screening method to identify the
population at risk and referral of such individuals for karyotyping, so
that, a strict watch may be kept for the early onset of symptoms.
22
1.7. DermatoglyphicResearch in Diabetes Mellitus:
Ziegler et al., (1993)in their research work on dermatoglyphics in
type 1 diabetes mellitushad analyzed thequantitative characteristics
of fingers and palms ridge count, qualitative parameters such as
digital and interdigital patterns and the position of the palmar axial
triradii.They concluded that dermatoglyphics is an interesting tool for
genetic studies related to type 1 diabetes.
Nezhad et al., (2010) in their research study emphasized that
unusualconditionsof dermatoglyphics in diabetics are valuable and
dermatoglyphics could be asuitable,noteworthy method for genetic
studies and type 1diabetes mellitus.
Padmini et al., (2011)in their research study on dermatoglyphics in
diabetes mellitus emphasized that though dermatoglyphics generally
do not play any important role in clinical diagnosis yet, it can serve as
an indicator to pickout subjects from a large group of people for
further investigations to confirm or rule out diabetes mellitus.
Sharma et al., (2012) in their research study on dermatoglyphics state
that with increased atd angles in the hands of both sides in the
patients in all the groupsexcept left side in males. Dermatoglyphics
23
can be used as a diagnostic tool to predict development of diabetes
at a later date.
Vadgaonkar et al., (2006) in their research study ondigito-palmar
complex in non-insulin dependent diabetes mellitus states that a
statistically significant increase in the atd angle was noted on both
right and lefthands of both sexes in diabetic. Their findings are
reliable indicators helpfulin scientific screening of populations prone
to diabetes mellitus.
Mehta et al., (2015) in their research study on fingerprint patterns in
type 2 diabetes mellitus states that their study can be used as a
screening tool for the diagnosis of individuals who are more prone to
develop diabetes mellitus and thereby preventing the future diabetic
complications.
Nayak et al., (2015) in their research work on dermatoglyphic study of
type 2diabetes mellitus emphasizes that qualitative fingertip
parameters such as arches, loops, whorls show fluctuating
asymmetry.Hence they are not useful for prediction of diabetes. The
atd angle is the only parameter which does not show fluctuating
asymmetry. This parameter is useful for detection of diabetes mellitus
by dermatoglyphic studies.
24
2. REVIEW OF LITERATURE
Barta et al., (1978) have carried out a dermatoglyphic study on 90
children and 180 adult diabetics and found a significant increase in
total finger ridge count and absolute finger ridge count in both female
and male with diabetes mellitus than in controls of both sexes.An
increase in theatd angles especially in males was observedin their
study.In both the hands of both sexes ahigher incidences of dat
angles was found. Whereas in the female diabetics an increased
incidence of simple arch pattern was noticed.
Ziegler et al., (1993) havecarried outquantitative and qualitative
dermatoglyphic study on type 1 diabetic patients. 88 male and 108
female type 1 diabetic patients were compared with 100 male and 99
female controls.Their results showed a lower ridge count in the third
finger and lower a-b ridge count in inter digital area compared with
controls. In addition, diabetic patients showed higher frequency of
palmar axial t' and t" triradii and a lower frequency of true patterns in
the fourth inter digital and thenar area than controls.
Bets et al., (1994) have carried out a studyon a group of children of
Russianorigin with clinically diagnosed diabetes mellitus.Children of
both sexes showed apattern asymmetry.A reduced incidence of loop
25
patterns was noticed in the study group. Among the boys a
higherincidence of arches and coils was noticed. Loops were lower
than in controls.Ingirls the incidence of radial and ulnar loops was low
with no arches. According to the researchers to assess the
significance of these signs as markers of risk of development of type
1diabetes mellitus dermatoglyphics analysis was an important tool.
Ravindranath et al., (1995) havestudied to determine specific
dermatoglyphic patterns in predicting the occurrence of maturity onset
Diabetes mellitus. The material for their study consisted of one
hundred and fifty patients, 75 males and 75 femalesalready
diagnosed cases of maturity onset type of non-insulin dependent
diabetes mellitus and 120 controls, 60 males and 60 females. The
Quantitative analyses included total finger ridge count and absolute
finger ridge count. The qualitative analysis consisted of finger tip
patterns of bothhands combined andseparately. The differences in
mean total finger ridge count found were insignificant. The differences
in mean absolute finger ridge count found were insignificant, but a
trend towards decrease in absolute finger ridge count in male patients
as compared with controls was observed at p - 0.07 significantlevels.
Both male and female diabetics showed a significant increase in
frequency of ulnar loops, radial loops and arches and a decreased
26
frequency of whorls. Withthe hands combined, the difference was
significant both in male and female diabetics by a preliminary analysis
by means of Chi squared test. Further, analysis with hands separate
showed that in males the difference was significant for both hands
and in females for the left hand.
Chakravarti.,(1967) found increase in finger print pattern whereas
Banerjee., (1985) reports decrease in finger print pattern in diabetic
patients compared to controls.
Vera et al., (1995) have compared the palmar dermatoglyphics of 158
insulindependent diabetic patients with the 400 controls. The main
dermatoglyphics alterations observed in diabetic patients and controls
were summarized as follows: (a). decrease in digital total ridges
count, (b). higher frequency in the number of arches, (c). decrease in
the sum of a line and cubital loops, particularly in female, (d).
increase in the number of t'axial triradii.
Sengupta et al.,(1996) have studied a sample of 60 male and 28
female individuals suffering from diabetes mellitus compared with
45male, 35female collected controls belonging to same ethnic group
and religious background with that of the patients. In case of male
diabetes mellitus patients, whorls were comparably more than loops.It
27
was reverse in case of female. Arch pattern in male shows relatively
higher frequency than in female. The inference arrived was relatively
less frequency of loop compared with control group in both the
sexes.Other finger patterns are found to be more in patient than in
controls. Among the diabetic patients, the total finger ridge count in
female was comparatively higher than male. On the contrary, in
normal series male showed much higher mean value than female. It
was also apparent that the diabetic patients record very low total
finger ridge count than their counterparts which was statistically
significant.
Eswaraiah et al., (1977) have compared thepalmar dermatoglyphicsof
108 male and 65 female diabetes mellituspatients with 536 male and
234 female controls.The flexion creases of diabetic patients and the
control population are significantly different. The differences between
main line formulae in diabetes and controls are significant among
males. The differences between 'C' line types of patients and controls
are significant among both sexes. Axial triradii are significant among
female patients and controls. The patterns in the interdigital areas IV
and II are significantly lower among male and female patients
respectively from their controls.
28
Igbigbi et al., (2001) have examined the plantar and digital prints of
the sole of 99 indigenous Malawian patients aged 25 – 66 years
attending the medical outpatient clinic for diabetes mellitus, essential
hypertension and a combination of the two conditions at Lilongwe and
Queen Elizabeth central hospitals. The group consisted of 27
diabetics (15 males, 12 females), 21 hypertensives (9 males,
12 females) and 51 diabetics with hypertension (21 males,
30 females). All patients were diagnosed as Type 2 diabetics after the
age of 20 years. Their results showed that soles of all patients had
more loops than arches and more arches than whorls, which were
restricted to the distal zones. In hypertension, whorls were found in
zones I, II and III whereas in patients with diabetes and hypertension,
the whorls were seen in zones I, III and IV. In digits the most
predominant ridge pattern was arches in all patients, followed by
loops and whorls were absent. In the first digit, diabetic patients had
no arches but women hypertensives showed arches. In patients with
diabetes and hypertension, arches were present in both sexes but in
men it was confined to the right foot. Loops were foundonlyin the first
digit in all patients. The frequency of loops was highest in diabetic
patients, high in diabetics with hypertension and least in patients with
hypertension alone.
29
Tarca et al., (2005) havestudied a total number of 133 patients with
Type 1Diabetes mellitus, out of which 58(33 males and 25
females)were children and teenagers of ages between 4 and 18
years. The disease manifested in these cases between the age of 2
and 17years. Among the female patientsthe loop was found in
approximately equal proportions in both the hands (58.95% on the left
hand and 60.60% on the right hand) whereasin case of normal
subject the loops were found on the leftside only. The loopdistribution
on the five fingers showed an increased frequency on the fingers from
V and III. Whorlswere more frequent in male series and on the right
hands.Archeswere more frequent in the female series. The
appearance of these markers, before the clinical manifestation of the
disease, makes possible for their use in prevention of insulin
dependent diabetes mellitus.
Ravindranath et al., (2005)havestudied fluctuating asymmetry from
quantitative parameters in dermatoglyphics of type 2 diabetes mellitus
compared to controls in the Bangalore based population. A total of
150 Type 2 diabetes mellitus, 75 males and 75 females from diabetic
clinic from specialists center and from St John’s Medical College,
Bangalore along with 120 controls, 60 Males and 60 Females were
studied. Their ages were 38 to 82 years. Fluctuatingasymmetry
30
measures derived from quantitative parameters, finger ridge counts,
a-b ridge counts and palmar angles were
analysed.Fluctuatingasymmetry measures were significantly higher in
type 2 diabetes mellitus males for the 5th finger (FA=2.04) and for the
palmar angle ‘dat’ (FA=2.24); for the Type 2 diabetes mellitus female
a high fluctuatingasymmetry was found in the 2nd finger (FA=2.17)
compared to controls. Fluctuatingasymmetry correlation coefficients
of a-b ridge countsand palmar angles in controls and type 2 diabetes
mellitus was not significant. Overall measures of the above ridge
counts and angles and their derived measures of
fluctuatingasymmetry were prominent features of type 2 diabetes
mellitus in this sample.
Vadgaonkar et al., (2006) have compared the dermatoglyphic pattern
of non-insulin dependent diabetes mellitus group with a normal adult
population.Both quantitative as well as qualitative parameters were
analyzed. The individuals in the control group were above the age of
40 years and had no significant personal or family history of diabetes
mellitus. Certain variations in total finger ridge count, absolute finger
ridge count, a-b ridge count, atd angle, additional axial triradii, pattern
intensity of fingers and principal digital pattern frequency were
compared. The wider atd angle and the presence of additional axial tri
31
radii became reliable indicators of diabetes. Their work emphasizes
that a wider atd angle and the additional axial triradii were seen as
reliable indicators helpful in scientific screening of populations prone
to diabetes mellitus. To conclude, dermatoglyphics can serve as a
ready screener to select individuals from a larger population for
further investigations to confirm or rule out diabetes mellitus.
Udoakaet al., (2009)have studied a total number of 90(50 males and
40 females) adult diabetic patients and compared with same number
of normal subjects as controls. There was no significant difference in
the digital patterns in the two groups. The atd angle, dat angle, the
total ridge count were significantly greater in the diabetic patients
compared to the normal subjects. The pattern intensity index was
higher in the diabetic males but it was lower in the female
diabetics.Their observations can be used for identification of
diabetics.
Nezhad et al., (2010)have studied 30 patients of diabetes type 1 and
30 normal subjects as control group. Mean age of patients and
control group was 22±11 and 38±8 respectively. Among these 42%
were males and 58% were females. They have found that the shape
of loop and whorl are heterogeneous and their number differ
significantly compare to control group (p = 0.001. p = 0.004.). The a-b
32
ridge count showed an increase in the ridge count among the diabetic
men than control group. The atd angle size in both test group and
control group of females was more than males. These authors are of
the opinion that dermatoglyphics can be a suitable method for genetic
studies and diabetes type 1.
Sumathi et al.,(2010) have studied a total of 100 patients of diabetes
mellitus Type 2 and hypertension of either sex or age group of 35-55
years. They were matched with hundred controls. They found
decreased a-b ridge count in female diabetics. The following
significant parameters have been found in their study in the palmar
dermatoglyphics in type 2 diabetes with hypertension. In both male
and female patients there is presence of decreased I1 pattern and
presence of increased I3 pattern in the left hand. Presenceof
decreased whorls noticed in both hands of male patients. Presenceof
increased ulnar loops and whorls in both hands of female patients.
Padmini et al., (2011)have studiedfinger prints and palmar prints from
200 subjects, 100 males and 100 females in the age group of 25
years to 80 years, of which 95% of cases were non-Insulin dependent
diabetics and 5% of cases were insulin dependent diabetics
compared with 200 controls.Higher incidence of variation in means of
ulnar loops (83.2), composite whorl (1.8), total finger ridge count
33
(108.6), absolute finger ridge count (138.55), dat angles of right hand
(59.77) and left hand (62.3) in diabetics than in controls were
observed by them. Rest of the parameters were low in diabetics than
in controls.
In male diabetics increase in means of ulnar loops (41.6), radial loops
(1.7), total finger ridge count (106.25), absolute finger ridge count
(137.58),atd angle of right hand (41.68) and left hand (41.67), dat
angles of left hand (62.42) and adt of right hand (80.45) was
observed than in controls.Infemale diabeticssignificant increase in
simple arches (5.7), total finger ridge count (110.94), absolute finger
ridge count (139.52), dat angles of both hands right (61.6) and left
hand (62.17) was observed than in controls.
Sharma et al., (2012) intheir study of 50 diabetic cases and 50
controls selected from the SMS Hospital, Jaipur, India, found that the
total finger ridge count, absolute finger ridge countand the a-b ridge
count were higher in all the patients.The atd angles in the hands of
both sides in the patients were increased in all the groups except left
side in males. But they differed significantly on the right side and on
the left side in female, p<.001.In the overall groups right tdaangle was
significant. The tad and the tda angles on both sides of the hands in
all the groups were lower in the patients except left tda angle in
34
males. But they differed only significantly in the left tad, right tda in
females. The results of their research work indicated that
dermatoglyphic abnormalities may be used as a diagnostic tool for
predicting the possibility of the development of diabetes at a later
date.
Taiwo et al., (2012) have carried out a study to clarify whether finger
print pattern of dermatoglyphics is associated withtype2 diabetes or
not. Dermatoglyphic data were obtained from controls and type 2
diabetic subjects attending the Diabetic Clinic of Lagos University
Teaching Hospital.They noticed total finger ridge count was
significantly higher (P<0.05) in diabetic subjects than in non-
diabetics. In view of the association between finger print pattern and
type2 diabetes, dermatoglyphics may be used for early identification
of risk group individuals for surveillance purposes with a view to
prevent disease onset.
Rakate et al., (2013) have compared the differences in the total finger
ridge count, a-b ridge count and atd angle in patients with type 2
diabetes mellitus with control group. Their study was carried out on
75 type 2 diabetic patients(51 male and 24 female) of 30 to 60 years
and 75 non – diabetic persons(47 males and 28 females) of the same
35
age group as a control group. In their study they found an increase in
number of whorls, total finger ridge count, a-b ridge count along with
wider atd angle in type 2 diabetes mellitus patients.
Khan et al., (2013) have emphasized that dermatoglyphic features
were strongly affected by genetic and environmental factors.Inthe
diagnosis of hereditary disorders usingdermatoglyphic featuresas
supportive evidence has become a reality. Their study evaluated the
relationship between dermatoglyphic features and non-insulin
dependent diabetes mellitus. Dermatoglyphic prints of one hundred
non-insulin dependent diabetes mellitus patients (50 male and 50
females) were taken for the study and compared with equal number
of healthy controls (50 males and 50 females). In diabetic patients
frequency of whorls were significantly increased. Frequencyof ulnar
loops were significantly decreased. The a-b ridge count was
significantly decreased in diabetics.
Desai et al., (2013) have opined that dermatoglyphics is a growing
discipline and its easy and ready applicability renders it as a useful
tool to the clinician. The dermatoglyphics is not to diagnoseand not
for defining an existing disease but to prevent by predicting a disease
and to identify people with genetic predisposition to develop certain
36
diseases. They have tried to determine significant palmar
dermatoglyphic parameters in case of sputum positive tuberculosis,
diabetes mellitus type 2 with essential hypertension, eczema,
congenital heart disease and Down syndrome and compared with the
control group. Their study indicated that there were some genetic
factors which were involved in the causation of various diseases
mentioned above. Itis possible to predict from dermatoglyphics
individuals chance of acquiring disease.Significantfindings they
observed were:1. Presence of decreased whorls, 2. Presence of
increased ulnar loops,3. Presence of increased simian line in the left
hand of studied patients.
Shivaleelaet al., (2013) have carried out a study to find the frequency
of various fingerprint patterns in type 2 diabetes mellitus with and
without ischemic heart disease. Their study also intended to find the
frequency of finger print patterns in type 2diabetes mellitus patients
having the family history of cardiovascular disease. Twenty five type
2diabetes mellitus male patients in the age group of 38-65 years were
selected, of which 18 had ischemic heart disease and 16 patients had
the family history of cardiovascular events. Therewas higher
frequency of whorls in type 2diabetes mellitus patientsthan other
patterns. Lessfrequency of arches, high frequency of whorls and ulnar
37
loops were observed in type 2diabetes mellitus patients compared
with type 2diabetes mellituspatients without ischemic heart disease.
The difference was not statistically significant. Dermatoglyphics in
type 2diabetes mellitus and in patients with family history of
cardiovascular disease did not show preponderance of any of the
fingerprints in ischemic heart disease. Therefore they opined
dermatoglyphics may be a diagnostic tool in type 2diabetes mellitus
but not in identifying the risk category for ischemic heart disease.
Umana et al., (2013) carried out a study to determine the association
between finger prints patterns and diabetes mellitus using subjects in
Zaria, Nigeria. Their results of 101 type 2 diabetic patients were
compared with 126 normal subjects. From their results there was an
association between finger print patterns of males with diabetes
mellitus. From the above study they concluded that the male with
arch pattern of finger print in their right hand are prone to develop
diabetes mellitus at a later stage.
Mittal et al.,(2013)have attempted to find an association of the
dermatoglyphics patterns of the healthy individuals and diabetes
mellitus patients. A total of 200 subjects participated in their study of
which 100 were diabetic patients (50 males and 50 females) and 100
were healthy individuals used as controls (50 males and 50 females).
38
The mean ‘atd’ angle in both the hands of both the sexes of diabetic
patients were found to be significantly wider as compared to that of
the controls.Compared to that of control,the mean tda angles in both
the hands of both the sexes of diabetics were found to be narrow.
The mean ‘dat’ angles were found to be significantly narrow only in
the left hand of diabetic females as compared to left hands of female
controls.
Burute et al., (2013) have aimed to study the various dermatoglyphic
patterns in the patients of the maturity onset diabetes mellitus (Type 2
diabetes mellitus) and compared with the dermatoglyphic patterns of
controls.They carried out their study on 101 (51 male and 50 female)
clinically diagnosed patients of maturity onset diabetes mellitus. For
comparison, healthy controls (Total =100, 50 males and 50 females)
were studied. Infemale diabetics significantly higher frequency of
arches and lower frequency of whorls were observed than in controls.
In diabetic females absolute finger ridge count and total finger ridge
count were significantly lower than in controls. Findingsof their study
highlights on the possible markers to predict type 2 diabetes mellitus
on a larger sample size after a meticulous analysis of different
fingertip dermatoglyphic variables.
39
Rakate et al.,(2014) have compared the differences on the fingertip
patterns namely,arch, loop, and whorl in patients with type 2 diabetes
mellitus with control group. Sample for their study comprised palmar
prints of 350 type 2diabetic patients of age group between 30-
60years out of them 240 were males and 110 were female compared
with same age group of 350 non-diabetic persons as control the
group, Out of them 240 were males and 110 were females. In the
sample of 350 type 2 diabetes mellitus patients, they observed an
increase in the number of whorls in both hands of males and females.
The P- value was 0.001. The Ulnar loop and arch patterns were
present in less value in diabetic patients which were statistically
insignificant. The plain whorl was present significantly higher in value
in diabetic patients of males and females. In diabetic males in right
hand 482 whorls where present. But in control only 326 whorls were
present; this difference was significant at 0.000 levels. In the left hand
of diabetic, whorl was significantly more 418 than control 267, P-value
was 0.000. Diabetic females also showed higher frequency of whorl
pattern in both hands; on right hand 158 compared with control 121
and 184 on left hand compared with 130. The P-values was 0.010 on
right hand and 0.000 on left hand. The Central pocket loop whorl
pattern observed more in diabetic patients. In diabetic male they
40
found 96 on right hand and on left hand 99 Central pocket loop whorl
pattern which was more compared with control right hand 82 and left
hand 82. The P-values were 0.138 and 0.094 respectively. In diabetic
females also Central pocket loop whorl was observed more right hand
36, left hand 40 than control group right hand 29 and left hand 36;P-
values were 0.237 and 0.320. The double loop whorl was observed
more in diabetic patients. In diabetic males on right hand 54 double
loop whorls were present which were more than control 38. Similarly
on left hand 69 in diabetic whereas 67 in control. The P-values were
0.044 and 0.430 respectively. In diabetic females also more
frequency of double loop whorl was observed on right hand 28
compared with control 15 and left hand 25 compared with 20 in
control. The P-values were 0.021 and 0.223.
When they compared all types of whorls together between diabetic
and control group, significant differences were observed in both
males and females. In diabetic males on right hand 632 whorls were
present which were more than 446 in normal. Similar findings were
observed on left hand 586 in diabetic whereas 416 in control. The p-
values were 0.000 and 0.000 respectively. In diabetic females also
more frequency of whorl was observed on right hand 222 compared
with control 165. The P-values were 0.000.
41
Sudagar et al., (2014)have carried out a study on 150 diabetic
patients, equal number of males and females, of age group ranging
from 30 to 70 years and an equal number of controls. In diabetic
males, the maximum percentage of a-b ridge count was seen
between 31-35 (34.6%) as compared to control males where it was
seen between 36-40 (34.6%). In diabetic females, the maximum
percentage of a-b ridge count was seen between 31-35 (36%) as
compared to control females where it was seen between 36-40
(35.3%). There was no statistically significant difference in the mean
value of a-b ridge count between cases and controls. In both diabetic
and control males, the maximum percentage of atd angle were seen
between 360-400 (49.3% & 46%) but percentagewise it differed. In
diabetic females, the maximum percentage of atd angle was seen
between 36-40 (42%) as compared to control females where it was
seen between 41-45 (39.3%). There was slight decrease in the mean
value of atd angle in cases as compared to the control groups but it
was not statistically significant. There was an increase in the
frequency of both t and t' and slight decrease in the frequency t" in
cases as compared to controls but it was not statistically significant.
Karim et al., (2014) have compared the differences in the finger print
patterns and finger ridge count in patients with type 2 diabetic mellitus
42
with control group in Erbil city, Kurdistan region, Iraq. In their study,
50 non-insulin dependent diabetes mellitus patients, 25 males and 25
females were compared with 50 (25 males and 25 females)healthy
controls.Thedistribution of finger tip patterns of male patients showed
no significant difference in ulnar loops, radial loops and tented arches
while plane arches increased significantly (P<0.05) in diabetic type 2
patients compared with controls, whorls decreased significantly
(P<0.05). Higher frequency of ulnar loops, radial loops and plane
arches in female diabetics compared with control females. They
observed that significantly increased (P<0.05) middle finger ridge
count in left hand of male diabetic patients. Significantly increased
(P<0.05) index and little finger ridge count of right hand was observed
in female diabetic patient compared with control female groups.
Nayak et al., (2015) havestudied the dermatoglyphic patterns and
their role in prediction of diabetes mellitus type 2 in Maharashtrian
population. Their study was carried out on 50 patients of type 2
diabetes mellitus. The control group for study consists of 50
subjects.Results showed that average number of arches, loops and
whorls in diabetics were not statistically significant as compared to
controls
(P > 0.05). The mean atd angle in diabetics was found to be 43.75 as
43
compared to 38.35 in non-diabetics population. P - Value
wasstatistically significant(P < 0.01). It means that the atd angle was
significantly increased in diabetics compared to non-
diabetics.Qualitativefingertip parameters such as arches, radial loops
and ulnar loops show fluctuating asymmetry and hence are not useful
for prediction of diabetescan be concluded by this study. Hence, it
can be concluded that atd parameter was useful for detection of
diabetes by dermatoglyphic studies sincethe only parameterwhich
does not show fluctuating asymmetry with previous studies was atd
angle.
Anju Bala et al., (2015) have studied a total 210 subjects out of which
70 subjects having diabetes (32 males and 38 females), 70 subjects
having diabetes with hypertension (32 males and 38 females) and 70
normal healthy individuals (32 males and 38 females) as control
belonging to Gangtok region of Sikkim. All were clinically diagnosed
and confirmed by investigations as diabetic and diabetic with
hypertensive patients. In their study,comparison of diabetic with
control group showed the mean values of atd and dat angles in both
hands of diabetic patients lower than control, whereas mean values of
adt angles were higher than control group on both right and left sides.
Significant difference was found in the right hands of diabetes mellitus
44
group. In the both right and left hands of male and female, the mean
values of atd angle and dat angle of diabetic group were lower than in
control.Themean values of adt angle were higher than control. No
significant difference was found. The mean values of a-b ridge count
in both hands were higher in diabetic male and female except in the
left hands of male and highly significant difference was found in both
hands of female.
Marera et al., (2015)have studied the dermatoglyphic patterns of 150
type 2 diabetes mellitus patientsand 150 controlsof Western Uganda.
Thewhorls (21%) most common pattern found in both hands of
female diabetic group but in male diabetic group, the predominant
pattern observedwere radial loops (11.87%). They concluded that the
findings of their study indicate possible markers for the use of
dermatoglyphics in early diagnosis of diabetes.
Sona Mohan et al., (2015) have evaluated the relationship between
dermatoglyphic patterns and type 2diabetes mellitus. They collected a
data on a total of 112 subjects of which 56 were diabetics (28 males
and 28 females) and 56 healthy individuals as control (28 males and
28 females). The atd, tda and datangles of the right and left hands of
diabetic and control group were measured. Theyobserved
45
significantly narrowed dat angle in right hand of male and female
diabetic patientscompared to controls with p - value< 0.05.
Mehta et al., (2015) have compared fingertip patterns of type 2
diabetic patientswith controls. One hundred type 2 diabetesmellitus
patients (50male and 50 female)were selected for study and
compared with equal number of controls.In both hands of males and
females diabetic patients frequency of whorls was significantly
increased. Frequencyof loops was significantly decreased in both
hands of male and female diabetics compared to controls. Arches
were significantly reduced in right and left hands of male diabetes
mellitus patients. Arches were significantly reduced in left hand of
female diabetics. In their study they stated that dermatoglyphics can
be used as a screening tool for the diagnosis of individuals who are
more prone to develop diabetes mellitus and thereby preventing the
future diabetic complications.
Anju Balaet al., (2016)havestudied a total of 100 type 2 diabetic
patients (50 males and 50 females) were compared with 100
diabetics with hypertension patientsof Hilly region. The mean values
of total finger ridge count and absolute finger ridge count were higher
in male and lower in female diabetic groupthan diabetic with
hypertension group. The mean values of a-b ridge count were lower
46
in male and higher in female in diabetic groupand a significant
difference was found. The mean values of atd angle were higher in
diabetic group than diabeticthan diabetic with hypertension group.
The mean values of dat angle were lower in right hands and higher in
left hands of diabetic group. The mean values of adt angle were
higher in males and lower in female diabetic groupthan diabetic with
hypertension group.In right hands, the mean values of fingertip ridge
counts were lower in all digits except in 2nd, 4th, and 5th digits in
male diabetic group.In left hands, the mean values of fingertip ridge
counts were lower in all digits of diabetic groupexcept in 2nd, 4th and
5th digits and no significant difference were found. In their study, they
observed an increase in ulnar loops in the right hand of male diabetic
and decreased frequency in the left hand of male and in both hands
of female diabetics.
47
3. NEED FOR THE STUDY
This study attempts to delineate the fingertips pattern and ridge
counts of diabetic patients in and around Salem district of Tamil Nadu
sincethere is a paucity of dermatoglyphic studies on diabeticpatients.
Many studies in India have shown links between diabetes mellitus
and dermatoglyphic patterns. Earlier researchers have used smaller
group of diabetic patients in their study. The present study has used a
large number of subjects (total number of 550 subjects, out of these
200 were normal subjects and 350 were diabetes mellitus type 1 and
type 2). No single study from India especially from south India
comparing the dermatoglyphic patterns oftype 1 and type 2diabetes
could be found in literature.
The assessment of predictive values of type 1 and type 2 diabetes
mellitus are helpful in the diagnosis of type 1 and type 2 diabetes
mellitus and predicting the onset of diabetes mellitus. Such a study
has scope for decreasing the morbidity and mortality due todiabetes
mellitus by creating awareness in the population.Dermatoglyphics can
serve as a ready screener to select individuals from a larger
population for further investigations to confirm or rule out diabetes
mellitus.
48
4. a. OBJECTIVES
1. To determine the quantitative dermatoglyphic pattern of type 1
diabetic patients.
2. To determine the qualitative dermatoglyphic pattern of type 1
diabetic patients.
3. To determine the quantitative dermatoglyphic pattern of type 2
diabetic patients.
4. To determine the qualitative dermatoglyphic pattern of type 2
diabetic patients.
5. To compare quantitative dermatoglyphic pattern of type 1 with
type 2 diabetic patients.
6. To compare qualitative dermatoglyphic pattern of type 1 with
type 2 diabetic patients.
4.b. HYPOTHESIS
The dematoglyphic studies can be useful for early prediction of type 1
and type 2 diabetes mellitus.
49
5. MATERIALS AND METHODS
5.1. Tools:Glass plate, round bottle, magnifyinghand lens, ink roller,
printers ink.
5.2. Method: Cummins and Midlo technique was used.
5.2.1. Procedure:After the written consent of the study subject, the
palm and finger prints were taken as follows. Patient was asked to
wash hands thoroughly with soap and water. Finger print pattern of
subjects were obtained by using ink smeared glass plate following
Cummins and Midlo technique as detailed below.
Glass plate was smeared with a thin layer of printers ink with the help
of roller. The hand of the subject was placed on the ink smeared
glass plate with a little pressure.The ink smeared hand was placed on
a sheet of bond paper kept on the round bottle. The hand was rolled
backwards from the root of the hands to tips of fingers, with minimum
pressure applied on the dorsum of the hand by the researcher. The
prints of each finger tips / inter digital areas / palms were taken on the
same paper for the second time for the safety measure.
50
Figure1. Glass plate smeared with ink with the help of roller.
Figure 2. Method of smearing ink to the palm of subject
fromGlass plate.
Glass plate Roller
Round bottle
Figure 3. Method of rolling ink smeared
Figure 4. Method of rolling ink smeared
51
Figure 3. Method of rolling ink smeared hand over the paper.
Figure 4. Method of rolling ink smeared hand over the paper.
over the paper.
over the paper.
52
5.3. Study Design: A total of 550 subjects were used for the study.
Out of the total 550 subjects 200 were normal subjects. One hundred
males between the ages of 36 to 85 years with a mean age of 53.93.
One hundred femalesbetween the ages of 35 to 80 years with a mean
age of 49.85. 150 type 1 proven diabetic patient included 100 males
between the ages of 18 to 46 years with a mean age of 26.45;
females were 50 between the ages of 13 to 38 years with a mean age
of 24.04. Onset of the type 1 diabetes in male patients was between 8
months to 30 years with a mean age of onset of 18.57. Onset of the
type 1 diabetes in female patients was between 2 to 27 years with a
mean age of onset of 17.64.
Two hundred type 2 proven diabetic patients included 100 males
between the ages of 30 to 81 years with a mean age of 53.47,
females were 100 between the ages of 35 to 75 years with a mean
age of 51.9. Onset of the type 2 diabetes in male patients was
between 28 years to 70 years with a mean age of onset of 48.59.
Onset of the Type 2 diabetes in female patients was between 30 to
70 years with a mean age of onset of 46.98. Biochemical parameters
were already assessed and the severity of the disease was recorded
and registered by the diabetic clinics.
53
5.3.1. Inclusion criteria: Patients diagnosed with type 1 and type 2
diabetes mellitus attending the diabetic clinic attached to Vinayaka
Missions University hospitals and other local Government and private
hospitals were used for this study. The individuals not suffering from
diabetes and without any family history of diabetes mellitus were
taken as control group.
5.3.2. Exclusion criteria: Patients suffering from skin conditions
which would affect the proper recording of the dermal ridges were
excluded from the study. Patients suffering from pregnancy induced
diabetes mellitus were also excluded. Diabetes mellitus due to any
other syndromes were also excluded from the study.
Patients suffering from
a) Anomalous development of the epidermis and its derivatives,
b) Excessive pigmentation of epidermis (Melanism),
c) Excessive production of cornified layer (Ichthyosis),
d) Naevus or mole (Benign proliferation of melanocytes),
e) Ectodermal dysplasia were also excluded from this study.
54
5.4. Parameters Observed:
5.4.1. Qualitative parameters:
5.4.1.1. Fingertip patterns:
Fingertip patterns of both right and left hands were noted for the
presence of following qualitative characteristics.
The ridge patterns of the fingertips are of three types: 1. Arches, 2.
Loops, 3. Whorls.
1. Arches: It is the simplest pattern formed by more or less parallel
ridges which traverse the pattern area and form a curve that is
concave proximally. Thecurve is gentlesometimes at other times it
swings more sharply. It may also be designated as a low or high
arch respectively. The arch pattern is subdivided into two types:
a).Simple arch (A)is composed of ridges that cross the
fingertip from one side to the other without recurving.
b). Tented arch (TA)is composed of ridges that meet at a point
so that their smooth sweep was interrupted.
2. Loops: A series of ridges enter the pattern area on one side of the
digit, recurve abruptly and leave the pattern area on the same side.
The loop pattern is subdivided into two types:
a).Ulnar loop (UL) is composed of ridges that open on the
ulnar side.
55
b). Radial loop(RL)is composed of ridges that open on the
radialside.
Occasionally, transitional loops (TRL – Transitional radial loop)
(TUL – Transitional ulnar loop) can be found which resemble
whorls or complex patterns.
3. Whorls (W):Any ridge configuration with two or more triradii. One
triradius is on radial and the other on the ulnar side of the pattern.
Subtypes of whorl patterns include:
a). Concentric whorl (CW):iscomposed of ridges that are
commonlyarranged as a succession of concentric rings or
ellipses.
b).Spiral whorl (SW): is a configuration in which ridges spiral
around the core in either a clockwise (SWCW – Spiral whorl
clock wise) or an anti clockwise (SWACW – Spiral whorl
anti-clock wise) direction.
c).Central pocket whorl (CPW): is a pattern containing a loop
within which a smaller whorl is located. Central pockets are
classified as ulnar (CPUW – Central pocketed ulnar whorl)
or radial (CPRW– Central pocketed radial whorl) according
to the side on which the outer loop opens.
56
d).Lateral pocket (LPULW – Lateral pocketed ulnar loop
whorl) (LPRLW– Lateral pocketed radial loop whorl)
pattern is composed of interlocking loops.
e).Double loop whorl (DLW) pattern is composed of double
loops and two triradii.
f). Accidentalwhorl (ACC.W) are one in which patterns cannot
be classified as one of the above patterns. Some represent a
combination of two or more configurations such as a loop
and a whorl, triple loops and other unusual formations.
57
Figure 5. Finger tip dermal ridge patterns.
Lateral Pocketed
Radial Loop Whorl
Lateral Pocketed
Ulnar Loop Whorl
Spiral Whorl Clock
wise
Spiral Whorl Anti-
clock wise
Central pocketed
Radial Whorl
Central pocketed
Ulnar Whorl
Radial Loop Ulnar Loop
Double Loop Whorl Concentric Whorl Accidental Whorl
Arch Tented Arch Transitional Radial
Loop
Transitional Ulnar
Loop
58
5.4.2. Quantitative Parameters:
5.4.2.1. Palmar Angles measurement:
1). atd angle: This angle was measured by lines drawn from the
digital triradius "a" to the axial triradius "t" and from this triradius to
the digital triradius "d". The more distal the position of "t", the
larger is atd angle.
2). dat angle: This angle was measuredby lines drawn from the
digital triradius "d" to the digital triradius "a" and from this triradius
to the axial triradius "t".
3). tda angle: This angle was measuredby lines drawn from the axial
triradius "t" to digital triradius "d'' and from this triradius to the
digital triradius "a".
59
Figure 6. Finger and palm print of right hand showing
palmarAngles.
a
d tda
dat
atd
t
60
5.4.2.2.Second, third and fourth inter digital area ridge count:
Figure 7. Second, third and fourth interdigital area.
The inter digital areas are the areas of distal palm between the
fingers. Thereare four digital triradii in the distal portion of the palm.
They are found in the metacarpal region at the base of digits II, III, IV
and V. Each triradius is normally associated with one digit. They are
termed a, b, c, and d, proceeding in a radio - ulnar direction.
Ridges are counted between two digital triradii. The ridge count that
was obtained between triradii “a” and “b” and is referred to as the a-b
ridge count. Similarly the ridge count that was obtained between 'b'
and 'c' triradii is referred to as b-c ridge count and 'c' and 'd' triradii is
referred to as c-d ridge count respectively. Counting is carried out
along a straight line connecting both triradial points. The count
excludes the ridges forming the triradii.
II
III
d
c b
a V
IV
c-d
b-c a-b
5.4.2.3.Fingertip ridge count
1. Finger ridge count of each of the ten fingers w
drawn from triradial point to the
2. Total number of
Figure 8: Method of
5. Statistical Analysis:
The values obtained by finger and palm print analysis were
statistically analyzed
1. Mean, standard deviation of all descriptive data was obtained.
2. Paired t test was used to compare the mea
d ridge counts, atd, dat and tda angles and total finger ridge
counts of both right and left hands.
Loop Spiral Whorl
61
tip ridge count analysis:
Finger ridge count of each of the ten fingers was
drawn from triradial point to the point of core.
number of ridges were counted.
: Method of Fingertip ridge count.
nalysis:
The values obtained by finger and palm print analysis were
analyzed with SPSS software version 16.0.
Mean, standard deviation of all descriptive data was obtained.
test was used to compare the means of a
d ridge counts, atd, dat and tda angles and total finger ridge
counts of both right and left hands.
Spiral Whorl Double loop Whorl
Concentric
as done by line
The values obtained by finger and palm print analysis were
Mean, standard deviation of all descriptive data was obtained.
ns of a-b, b-c and c-
d ridge counts, atd, dat and tda angles and total finger ridge
Concentric Whorl
62
6. RESULTS AND DISCUSSION
Manyinvestigators have been utilizing the quantitative features of
dermatoglyphics, realizing the need for more objective means of
dermatoglyphic analysis, such as counting individual ridges within a
pattern or elsewhere between two well defined points or using
angular measurements. This quantitative approach has contributed to
an understanding of the genetical influence on dermatoglyphics.
A comprehensive review of genetics of the quantitative
dermatoglyphic traits has been published by Holt that represents a
significant contribution of research in this field.
At present, the heredity of most dermatoglyphic features conforms to
a polygenic system, with individual genes contributing a small additive
effect. Modern cytogenetic methods are certain to be of great value,
in studying the correlations between individual chromosome
aberrations and dermatoglyphic features and may lead to establishing
the loci of genes that influence dermatoglyphics. A limitation to the
precise genetic analysis of dermatoglyphics is the difficulty in
delineating some features and reducing them to quantifiable
characteristics. Many transitional features exist and too much latitude
for subjective classification is still possible. Improvements in the
reliability of classification and more precise delineation of
63
dermatoglyphic features will undoubtedly of genetic factors in the
development of epidermal ridge configurations.
6.1. Quantitative dermatoglyphic pattern of Type 1
diabeticpatients.
Table 1: Comparison of palmar angles between Type 1 Diabetes
mellitus and normal subjects.
Parameters Male subjects Female Subjects
Normal Type 1 DM P value
Normal Type 1 DM P value Mean SD Mean SD Mean SD Mean SD
Right atd 42.75 4.88 42.9 4.99 >0.05 44.78 6.43 44.68 8.93 >0.05
Right dat 58.22 4.91 58.02 5.31 >0.05 57.55 5.49 53.52 9.3 <0.05*
Right tda 78.91 3.79 79.69 3.65 >0.05 77.64 4.67 77.98 11.8 >0.05
Left atd 43.74 5.45 44.53 5.01 >0.05 44.83 5.6 47.12 6.43 <0.05*
Left dat 59.64 4.52 58.89 5.28 >0.05 58.77 5.73 56.36 5.68 <0.05*
Left tda 76.56 3.98 77.08 3.97 >0.05 76.19 4.27 76.32 3.76 >0.05
Statistical analysis was done by t-test, Data expressed as mean and SD.
* P-value < 0.05 was considered as statistically significant.
Statistically increased levels of right tda (79.69), left atd (44.53) and
left tda (77.08) angles in male type 1 diabetes mellitus patients
compared to normal male subjects, right tda (78.91), left atd (43.74)
and left tda (76.56) angles but these values were statistically
insignificant.
Significantly decreased levels of right dat (53.52) and left dat (56.36)
angles in female type 1 diabetes mellitus patients compared to
normal female subjects, right dat (57.55) and left dat angles (58.77).
Significantly increased level of left atd angle (47.12) in female type 1
diabetes mellitus patients compared to normal female subjects
(44.83).
64
42.9
58.02
79.69
44.53
58.89
77.08
42.75
58.22
78.91
43.74
59.64
76.56
Right atd Right dat Right tda Left atd Left dat Left tda
Comparision of palmar angles between Type 1 male diabetes mellitus and normal Male subjects
Male Type 1 DM Normal Male
Parameters
Me
an
44.68
53.52
77.98
47.12
56.36
76.32
44.78
57.55
77.64
44.83
58.77
76.19
Right atd Right dat Right tda Left atd Left dat Left tda
Comparison of palmar angles Between Female Type1 diabetes mellitus and Normal Female
SubjectsFemale Type 1 DM Normal Female
Parameters
Me
an
Fig 9.
Fig 10.
65
No studies have been published relating to tad and adt angles in
Type 1 diabetes mellitus so far for comparison. Hence, though the
following Vera et al., (1995) study was conducted in type 1 diabetes
mellitus with joint mobility is compared with the present study.
Vera et al., (1995) have observed that the increased level of mean
value of atd angle in both male (90.46) and female (89.53) type 1
diabetes mellitus with limited joint mobility and type 1 diabetes male
(86. 57) and female (87.39) without limited joint mobility compared to
control male (83.60) and female(86.40). In their study, the angle was
higher compared to the present study, which may be due to racial
differences.
Table 2: Inter digital areas ridge count between Type 1 Diabetes
mellitus and Normal subjects.
Parameters Male subjects Female Subjects
Normal Type 1 DM P value
Normal Type 1 DM P value Mean SD Mean SD Mean SD Mean SD
Right a-b 41.08 6.12 41.5 5.3 >0.05 39.87 4.74 42.66 5.54 <0.05*
Right b-c 26.16 7.47 24.48 8 >0.05 24.22 7.35 26.94 5.19 <0.05*
Right c-d 36.62 7.86 36.23 10 >0.05 35.59 8.18 38.66 6.72 <0.05*
Left a-b 42.87 5.73 42.66 4.99 >0.05 41.53 5.02 44.3 6.69 <0.05*
Left b-c 24.72 8.1 23.3 8.85 >0.05 23.13 8.57 24.66 7.44 > 0.05
Left c-d 36.48 10.7 36.14 12.9 >0.05 34.83 11.3 38.78 9.33 <0.05*
Statistical analysis was done by t-test, Data expressed as mean and SD.
* P-value < 0.05 was considered as statistically significant.
In male type 1 diabetes mellitus patients a-b ridge count (41.5) was
insignificant and equal to normal subjects (41.08), decreased levels of
66
41.5
24.48
36.23
42.66
23.3
36.14
41.08
26.16
36.62
42.87
24.72
36.48
Right a-b Right b-c Right c-d Left a-b Left b-c Left c-d
Inter digital areas ridge count between Type 1 male diabetes mellitus and Normal male subjects
Male Type 1 DM Normal Male
Mean
Parameters
39.87
24.22
35.59
41.53
23.13
34.83
42.66
26.94
38.66
44.3
24.66
38.78
Right a-b
Right b-c
Right c-d
Left a-b
Left b-c
Left c-d
Inter digital areas ridge count between Type 1 Female diabetes mellitus and Normal Female
subjectsFemale Type 1 DM Normal Female
Para
mete
rs
Mean
Fig 11.
Fig 12.
67
right b-c (24.48) and left b-c (23.3) ridge counts compared to normal
male subjects, right b-c (26.16) and left b-c (24.72) were noted.
These values were statistically insignificant in male type 1 diabetic
patients in the present study.
Significantly increased levels of right a-b(42.66), b-c (26.94) and c-d
(38.66) ridge counts were noted in female type 1 diabetes mellitus
patients compared to normal female subjects, right a-b (39.87), b-c
(24.22) and c-d (35.59) ridge counts.
Significantly increased levels of left a-b (44.3) and c-d (38.78) ridge
count in female type 1 diabetes mellitus patients compared to normal
female subjects, left a-b (41.53) and c-d (34.83) ridge count were
noted.
Nezhad et al., (2010)observed that the decreased levels of a-b count
in male and female patients compared to control groupwasstatistically
not significant. In the present study significant differences in the
values of a-b ridge count between female type 1 diabetes
mellituspatients and normal female subjects werenoted.
Shield et al., (2012) have found no difference in the a-b ridge counts
on either hand (right hand diabetics: mean 42, controls: 41, which
was insignificant; left hand diabetics: 43, controls: 42, which was
insignificant) contrary to the present study.
68
Ziegler et al, (1993) reported a decreased a-b ridge count (p < 0.001)
in both male and female type 1 diabetics (right hand mean values 31
and left hand 32) compared to the control group (right hand mean
values 40 and left hand 41), contrary to our study.
Table 3: Finger tip Ridge Count between Type 1 Diabetes
mellitus and normal subjects.
Parameters Male subjects Female Subjects
Normal Type 1 DM P value
Normal Type 1 DM P value Mean SD Mean SD Mean SD Mean SD
Right thumb 19.11 6.44 17.83 5.16 >0.05 15.9 5.66 16.36 5.65 >0.05
Right index 13.41 6.34 11.32 6.27 <0.05* 11.1 6.01 12.04 6.38 >0.05
Right middle 13.69 6.09 11.99 5.63 <0.05* 12.21 5.39 12.34 5.08 >0.05
Right ring 17.09 5.56 15.21 5.2 <0.05* 14.37 5.18 15.56 5.21 >0.05
Right little 13.76 4.67 13.03 4.86 >0.05 11.42 4.83 12.56 4.65 >0.05
Left thumb 18.29 6.44 16.15 5.39 <0.05* 14.09 6.32 15.36 5.46 >0.05
Left index 12.06 7.16 11.21 6.65 >0.05 10.07 6.6 11.24 6.55 >0.05
Left middle 13.86 6.08 13.27 6.21 >0.05 12.01 5.7 12.38 6.6 >0.05
Left ring 17.74 6.37 15.45 6.39 <0.05* 14.35 5.12 14.68 5.3 >0.05
Left little 14.43 4.77 13.72 4.86 >0.05 12.02 4.74 12.44 4.93 >0.05
Statistical analysis was done by t-test, Data expressed as mean and SD.
* P-value < 0.05 was considered as statistically significant.
Decreasedlevels of finger tip ridge count of right thumb, right index,
right middle, right ring, right little, leftthumb, left index, left middle, left
ring, left little fingers in type 1 male patients compared to normal male
subjects but these values were statistically insignificant.
Significantly decreased levels of finger tip ridge count of right
index(11.32), right middle (11.99), right ring (15.21), left thumb
(16.15) and left ring (15.45) fingers in type 1 male patients compared
to normal
69
19
13
14
17
14
18.29
12.06
13.86
17.74
14.43
18
11
12
15
13
16.15
11.21
13.27
15.45
13.72
Right thumb
Right index
Right middle
Right ring
Right little
Left thumb
Left index
Left middle
Left ring
Left little
Finger tip Ridge Count between Type 1 male diabetes mellitus and Normal male subjects
Male Type 1 DM Normal Male
Pa
ram
ete
rs
Mean
15.9
11.1
12.21
14.37
11.42
14.09
10.07
12.01
14.35
12.02
16.36
12.04
12.34
15.56
12.56
15.36
11.24
12.38
14.68
12.44
Right thumb
Right index
Right middle
Right ring
Right little
Left thumb
Left index
Left middle
Left ring
Left little
Finger tip Ridge Count between Type 1 Female diabetes mellitus and normal Female subjects
Female Type 1 DM Normal Female
Pa
ram
ete
rs
Mean
Fig13.
Fig 14.
70
male subjects, right index (13.41), right middle (13.69), right ring
(17.09) left thumb (18.29) and left ring (17.74) fingers.
Ziegler et al., (1993) reported lowervalues in finger ridge count (p <
0.05) in the third finger in type 1 diabetic male and female patients.
The present study coincides with this study only for right middle finger
ridge count of female type 1 diabetes mellitus but in male type 1
diabetes mellitus it was insignificantly increased in left middle finger.
There was no significant difference observed in right middle finger
ridge count in male type 1 diabetes mellitus.
Table 4: Total finger ridge count between Type 1 Diabetes
mellitus and Normal subjects.
Parameter Male subjects Female Subjects
Type 1 DM Normal P value
Type 1 DM Normal P value Mean SD Mean SD Mean SD Mean SD
TFRC 139.2 46 153.4 46.9 <0.05* 135 45 127.5 42.5 >0.05
Statistical analysis was done by t-test, Data expressed as mean and SD.
* P-value < 0.05 was considered as statistically significant.
Total finger ridge count in type 1 male diabetics shows that the mean
value was 139.18 compared to total finger ridge count in normal
subjects shows that mean value was 153.42 with a significant p -
value of < 0.05.
Total finger ridge count in type 1 female diabetics shows that the
mean value was 134.96 compared to total finger ridge count in
71
normal subjects shows that mean value was 127.5 with an
insignificant p value.
Vera et al., (1995) though noted decreased levels of total finger ridge
count in both sexes it was statistically significant only in female type 1
diabetes mellitus patients compared to controls. In contrast to the
above Vera et al.,(1995) study, in the present study it was noted that
total finger ridge count was statistically significant only in male type 1
diabetic patients.
Since none of the previous researchers had such an individual finger
study to compare with the present study, in the following tabular
columns the finger tip patterns of all the digits in both the hands of
type 1 diabetic patients and normal subjects were recorded as the
first of its kind in dermatoglyphic research.Since no study was
available similar to the present study in the literature, the results of
the present studycould not be compared.
72
6.2. Qualitative dermatoglyphic pattern of Type 1 Diabetic
patients.
Table 5: Qualitative dermatoglyphic pattern of thumb of Type 1
Diabetes mellitus patients.
Patterns
Male Subjects Female Subjects Normal Type 1 DM Normal Type 1 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 41 44 49 52 55 43 56 52
TUL 0 4 2 0 1 1 2 0
Total 41 48 51 52 56 44 58 52
Radial loops
RL 0 0 2 1 1 1 0 0
TRL 0 0 0 1 0 1 0 0
Total 0 0 2 2 1 2 0 0
Whorls
DLW 15 28 15 32 14 27 18 28
SWCW 6 17 5 10 2 12 4 14
SWACW 22 0 19 0 16 0 8 0
CPUW 3 1 2 0 1 2 0 0
CPRW 4 0 2 1 0 3 0 2
LPULW 6 1 3 1 6 2 6 0
LPRLW 0 2 0 1 0 0 2 2
CW 1 0 1 0 0 0 0 0
ACC. W 0 0 0 0 0 0 0 0
Total 57 49 47 45 39 46 38 46
Arches
A 2 0 0 1 4 8 4 2
TA 0 0 0 0 0 0 0 0
Total 2 0 0 1 4 8 4 2
Data expressed in percentage.
Vera et al., (1995) observed that an increased percentage of arch in
male type 1 diabetes mellitus and decreased percentage of ulnar loop
in female type 1 diabetes mellitus with limited joint mobility compared
to type 1 diabetes mellitus without limited joint mobility.
Tarca et al., (2005) observed that a substantial reduction of the
frequency for loops (L), with a sensible increase of the frequency for
73
whorls (W) and arches (A). The environment factors from the prenatal
life act in the post-natal period, being responsible for the release and
clinical manifestation of the properdisease. The results they got, even
if they were the first of this type in their country, support the idea of
using dermatoglyphics, a less costly and easier to reproduce in any
stage of post-natal life as marker, together with metabolic,
immunologic and genetic markers, in predicting a potential
diabetogen risk at the population level.
In the present study it was observed that there was an increased
percentage of rightand left thumbulnar loop pattern in both type 1
male and type 1 female diabetes mellitus patients than normal males
and females. Decreased percentage of right and left thumb whorls
pattern was observed in both type 1 male and type 1 female diabetes
mellitus patients than normal males and females.
74
Table 6: Qualitative dermatoglyphic pattern of index finger of
Type 1 Diabetes mellitus patients.
Patterns
Male subjects Female subjects
Normal Type 1 DM Normal Type 1 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 30 35 40 33 54 43 58 36
TUL 2 0 1 2 0 0 4 0
Total 32 35 41 35 54 43 62 36
Radial
loops
RL 7 4 5 7 5 9 2 4
TRL 1 0 2 1 2 2 0 0
Total 8 4 7 8 7 11 2 4
Whorls
DLW 6 9 5 4 6 5 4 10
SWCW 10 24 4 15 9 13 8 8
SWACW 16 0 9 3 5 0 4 6
CPUW 2 0 3 2 1 0 2 2
CPRW 10 10 13 17 4 10 6 10
LPULW 5 3 4 0 3 0 0 4
LPRLW 2 0 2 3 1 1 2 4
CW 0 0 0 0 0 0 0 0
ACC.W 1 0 0 0 0 0 0 0
Total 52 46 40 44 29 29 26 44
Arches
A 7 10 10 1 8 14 8 12
TA 1 5 2 0 2 3 2 4
Total 8 15 12 1 10 17 10 16
Data expressed in percentage.
Intype 1 male diabetes mellitus patientsincreased percentage level of
ulnar loop pattern was observed in right index finger (40%) compared
to normal males (30%). In type 1 male diabetes mellitus
patientsincreased percentage level of radial loop pattern was
observed in left index finger (8%) compared to normal males
(4%).Decreased percentage level of whorls pattern was observed in
both right (40%) and left (44%) indexfingers of type 1diabetes mellitus
males compared to normal males,right (52%) and left (46%) index
75
fingers. Increased percentage level of arch pattern in right index
finger (12%)and decreased percentage level of arch pattern in left
index finger (1%) was observed in type 1 male diabetes mellitus
patients compared to normal males, right (8%)and left (15%) index
fingers.
Increased percentage level of ulnar loop pattern in right index finger
(62%)and decreased percentage level of ulnar loop pattern in left
index finger (36%) was observed in type 1femalediabetes mellitus
patients compared to normal femalesright(54%) and left (43%) index
fingers.Decreased percentage level of radial loop patterns was
observed in both right (2%)and left (4%) indexfingers of type 1female
diabetes mellitus compared to normal females, right (7%)and left
(11%)indexfingers.Intype1femalediabetes mellitus patientsincreased
percentage level of whorls pattern was observed in left index
finger(44%) compared to normal females (29%). In femalediabetes
mellitus patients compared to normal females, no differences were
observed in arch pattern of both right and left index fingers.
76
Table 7: Qualitative dermatoglyphic pattern of middle finger of
Type 1 Diabetes mellitus patients.
Patterns
Male subjects Female subjects
Normal Type 1 DM Normal Type 1 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 58 51 68 61 78 69 82 60
TUL 4 3 0 2 0 2 0 2
Total 62 54 68 63 78 71 82 62
Radial
loops
RL 0 0 0 1 0 0 0 0
TRL 0 0 0 0 0 0 0 2
Total 2 0 0 1 0 0 0 2
Whorls
DLW 2 13 2 10 1 4 2 10
SWCW 3 16 5 12 2 11 0 10
SWACW 14 1 11 0 4 0 10 2
CPUW 8 0 0 2 4 1 2 0
CPRW 2 3 1 2 1 3 0 2
LPULW 0 2 4 0 4 2 0 0
LPRLW 2 2 0 2 0 0 0 0
CW 0 0 0 0 0 0 0 0
ACC.W 0 0 1 0 1 0 0 0
Total 31 37 24 28 17 21 14 24
Arches
A 7 9 7 7 4 7 4 10
TA 0 0 1 1 1 1 0 2
Total 7 9 8 8 5 8 4 12
Data expressed in percentage.
Increased percentage level of ulnar loop pattern was observed in both
right (68%) and leftmiddle (63%) fingers in type 1 male diabetes
mellitus patients compared to normal males,right (62%) and left
(54%)middle fingers. Decreased percentage level of whorls pattern
was observed in both right (24%) and left(28%) middle fingers in type
1 male diabetes mellitus patients compared to normal males,right
(31%) and left(37%) middle fingers. No differences were observed in
77
arch pattern of right and left middle fingers of maletype 1 diabetes
mellitus patients compared to normal males.
Increased percentage level of ulnar loop pattern in right middle
finger(82%) and decreased percentage level of ulnar loop pattern in
left middle finger (62%) was observed in type 1femalediabetes
mellitus patients compared to normal females,right (78%) and
left(71%) middle fingers. Decreased percentage level of whorls
pattern in right middle (14%) and increased percentage level of
whorls pattern in leftmiddle fingers(24%) was observed in type
1female diabetes mellitus patients compared to normal females,right
(17%) and left(21%) middle fingers. Increased percentage level of
arch pattern in leftmiddle fingers(12%) was observed in type
1femalediabetes mellitus patients compared to normal females (8%).
78
Table 8: Qualitative dermatoglyphic pattern of ring finger of Type
1 Diabetes mellitus patients.
Patterns
Male subjects Female subjects
Normal Type 1 DM Normal Type 1 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 29 23 28 33 48 48 38 30
TUL 3 5 7 10 7 8 4 12
Total 32 28 35 43 55 56 42 42
Radial
loops
RL 0 0 0 0 0 1 0 2
TRL 0 0 0 0 0 0 0 0
Total 0 0 0 0 0 1 0 2
Whorls
DLW 0 3 1 1 1 2 2 2
SWCW 23 40 11 34 14 31 10 32
SWACW 16 1 8 1 5 3 14 4
CPUW 27 13 41 11 22 4 28 12
CPRW 0 1 0 3 1 1 0 2
LPULW 0 10 1 5 0 0 4 0
LPRLW 0 0 0 0 0 0 0 0
CW 0 1 2 0 0 0 0 0
ACC.W 0 0 1 1 1 1 0 2
Total 66 69 65 56 44 42 58 54
Arches
A 2 3 0 1 1 1 0 2
TA 0 0 0 0 0 0 0 0
Total 2 3 0 1 1 1 0 2
Data expressed in percentage.
Increased percentage level of ulnar loop pattern was observed in both
right (35%) and left (43%) ring fingers in type 1 male diabetes mellitus
patients compared to normal males,right (32%) and left (28%) ring
fingers. Decreased percentage level of whorls and arches pattern
were observed in both right (65%) and left(56%) ring fingers in type 1
male diabetes mellitus patients compared to normal males,right
(66%) and left(69%) ring fingers.
79
Decreased percentage level of ulnar loop pattern in right (42%) and
left (42%) ring fingerswas observed in type 1femalediabetes mellitus
patients compared to normal females,right (55%) and left (56%) ring
fingers. Increased percentage level of whorls pattern in right (58%)
and left(54%) ring fingerswas observed in type 1femalediabetes
mellitus patients compared to normal females,right (44%) and left
(42%) ring fingers.
Table 9: Qualitative dermatoglyphic pattern of little finger of
Type 1 Diabetes mellitus patients.
Patterns
Male subjects Female subjects
Normal Type 1 DM Normal Type 1 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 64 63 62 68 75 71 78 64
TUL 4 6 7 4 2 3 4 4
Total 68 69 69 72 77 74 82 68
Radial
loops
RL 0 0 0 0 0 0 0 0
TRL 0 0 0 0 0 1 0 0
Total 0 0 0 0 0 1 0 0
Whorls
DLW 0 1 0 0 0 0 0 0
SWCW 3 18 2 17 4 13 2 24
SWACW 5 0 4 0 1 1 2 0
CPUW 21 6 21 3 15 3 12 2
CPRW 0 0 0 0 0 1 0 0
LPULW 3 6 4 6 3 5 2 4
LPRLW 0 0 0 0 0 0 0 0
CW 0 0 0 0 0 1 0 0
ACC.W 0 0 0 1 0 0 0 0
Total 32 31 31 27 23 24 18 30
Arches
A 0 0 0 1 0 1 0 2
TA 0 0 0 0 0 0 0 0
Total 0 0 0 1 0 1 0 2
Data expressed in percentage.
80
Increased percentage level of ulnar loop pattern was observed in both
right (69%) and left (72%) little fingers in type 1 male diabetes
mellitus patients compared to normal males, right (68%) and left
(69%) little fingers.Decreasedpercentage level of whorls pattern was
observed in both right (31%) and left (27%) little fingers in type 1 male
diabetes mellitus patients compared to normal males, right (32%) and
left (31%) little fingers.
Increased percentage level of ulnar loop pattern in right (82%) little
fingers and decreased percentage level of ulnar loop pattern in left
(68%) little fingerswas observed in type 1femalediabetes mellitus
patients compared to normal females, right (77%) and left (74%) little
fingers. Decreased percentage level of whorls pattern was noted in
right (18%) little finger but it was increased inleft(30%) little finger of
type 1femalediabetes mellitus patients compared to normal females,
right (23%) and left (24%) little fingers.
The following inferences were drawn after the analysis of the data of
the present study which involve large number of subjects.
In type 1 male diabetes mellitus patients increased percentage level
of following finger tip patterns facilitate in predicting diabetes mellitus
manifestation at a later stage.
81
� 1. Thumb - Ulnar loopin both right and left hand, 2. Index finger-
Ulnar loopin right hand and Radial loop in left hand,3.
Middlefinger -Ulnar loop in both right and left hand,4. Ringfinger
- Ulnar loop in both right and left hand,5. Little finger -Ulnar loop
in both right and left hand.
Ridge count parametersshowed significant values with which type 1
male diabetes mellitus could be confirmed.
� Left ring (p< 0.05), left thumb (p< 0.05), right ring (p < 0.05),
right index (p< 0.05) and right middle(p< 0.05)fingers ridge
count.
In type 1 female diabetes mellitus patients increased percentage level
of following finger tip patterns facilitate in predicting diabetes mellitus
manifestation at a later stage.
� 1. Thumb- Ulnar loopin both right and left hand, 2. Index finger -
Ulnar loopin right hand, Whorls in left hand, 3. Middle finger -
Ulnar loopin right hand, Whorls in left hand, Arches in left
hand,4. Ringfinger - Whorls in both right and left hand, 5. Little
finger - Ulnar loop in right hand, Whorls in left hand.
Ridge count parameters significant values with which type 1 female
diabetes mellitus could beconfirmed.
Right tad (p< 0.05), left tad (p< 0.05) and left atd (p< 0.05) angles.
82
Right a-b (p< 0.05), left a-b (p< 0.05), right b-c (p< 0.05), right c-d (p<
0.05) and left c-d (p< 0.05) inter digital areas ridge count.
6.3. Quantitative dermatoglyphic pattern of Type 2 Diabetic
patients.
Table 10: Comparison of palmar Angles between Type 2
Diabetes mellitus and Normal subjects.
Parameters Male subjects Female Subjects
Normal Type 2 DM P value
Normal Type 1 DM P value Mean SD Mean SD Mean SD Mean SD
Right atd 42.75 4.88 43.21 7.84 >0.05 44.8 6.43 45.75 6.25 >0.05
Right dat 58.22 4.91 57.25 7.77 >0.05 57.6 5.49 56.7 5.73 >0.05
Right tda 78.91 3.79 78.16 9.26 >0.05 77.6 4.67 78 4.16 >0.05
Left atd 43.74 5.45 43.38 5.95 >0.05 44.8 5.6 45.77 5.85 >0.05
Left dat 59.64 4.52 59.86 5.13 >0.05 58.8 5.73 57.89 5.88 >0.05
Left tda 76.56 3.98 76.37 5.49 >0.05 76.2 4.27 76.82 3.78 >0.05
Statistical analysis was done by t-test, Data expressed as mean and SD.
* P-value > 0.05 was statistically significant.
Inmale type 2diabetes mellitus patients compared to normal male
subjectsright atd angle (42.75) with increased level of right atd angle
(43.21) was insignificant. In male type 2diabetes mellitus patients with
decreasedlevel of right dat angle (57.25) compared to normal male
subjects right datangle(58.22) was insignificant.
In the present study it was observed that right atd (45.75), right tda
(78) and left atd (45.77) angles in female type 2diabetes mellitus
patients compared to right atd (44.78), right tda (77.64) and left atd
(44.83) angles of the normal female subjects were insignificant.
83
The comparison of palmar angles between type 2 diabetes mellitus
and normal subjectspresent study was found to be statistically
insignificant which coincides with the studies ofSona Mohan et al.
(2015),Ravindranath et al. (2005) and Mittal et al. (2013), on the
contrary statistically significant findings were found by Padmini et al.
(2011),Vadgaonkar et al. (2006) andUdoaka et al. (2009).
Sona Mohan et al., (2015) have observed that a decreased mean
value of left atd (40.37), left dat (81.67), right tda (58) and right dat
(80.87) angles compared to controls, left atd (41.25), left dat (82.14),
right tda (56.46) and right dat (82.67) angles, except right dat angle,
all other values were insignificant.
Ravindranath et al., (2005)have observed that significant decrease
mean value of dat angle in both male and female.
Mittal et al., (2013) have observed that there was statistically
significant difference in ‘atd’ angle and ‘tda’ angle of diabetic and
control group (p value < 0.05). The ‘dat’ angle in control and diabetic
group on right were 59.39 and 58.52 respectively while on left were
59.44 and 58.36 respectively. There was no statistically significant
difference in ‘dat’ angle of diabetic and control group (p-value > 0.05).
84
44.78
57.55
77.64
44.83
58.77
76.19
45.75
56.7
78
45.77
57.89
76.82
Right atd
Right tad
Right adt
Left atd
Left tad
Left adt
Comparison of palmar Angles between Type 2 Femalediabetes mellitus and Normal Female subjects
Female Type 2 DM Normal Female
Pa
ram
ete
rs
Mean
43.21
57.25
78.16
43.38
59.86
76.37
42.75
58.22
78.91
43.74
59.64
76.56
Right atd Right dat Right tda Left atd Left dat Left tda
Comparison of palmar angles between Type 2 male diabetes mellitus and normal male subjects
Male Type 2 DM Normal Male
Parameters
Me
an
Fig 15.
Fig 16.
85
Padmini et al., (2011)observedthat there was an increase in means of
atd angle of right hand (41.68)and left hand (41.67) in male diabetics
compared withatd angle of right hand (39.15)and left hand (40.92)of
control subjects.Therewas an increase in means of dat angles of left
hand (62.42) of diabetic patients compared with controlsdatangles of
left hand (56.62). Therewas an increase in means of adt angle of right
hand (80.45) in male diabetics compared with controls adtangle of
right hand (78.38).There was significant increase in dat angles of both
hands, right (61.6) and left (62.17) in female diabetics than in controls
with means of dat angles of right hand (57.67), left hand (55.2).
Vadgaonkar et al., (2006) showed a statistically significant increase in
the ‘atd’ angle in diabetics of both sexes compared with controls
which showed acute angles.
Udoaka et al., (2009)observed that significantincrease in dat angle
and atd angle in the diabetics than in the normal subjects.
86
Table 11: Inter digital areas ridge count between Type 2 Diabetes
mellitus and normal subjects.
Parameters Male subjects Female Subjects
Normal Type 2 DM P value
Normal Type 2 DM P value Mean SD Mean SD Mean SD Mean SD
Right a-b 41.08 6.12 38.32 6.55 <0.05* 39.87 4.74 39.81 4.95 >0.05
Right b-c 26.16 7.47 25.01 6.39 >0.05 24.22 7.35 26.62 5.9 <0.05*
Right c-d 36.62 7.86 35.96 5.31 >0.05 35.59 8.18 36.41 7.57 >0.05
Left a-b 42.87 5.73 39.4 5.43 <0.05* 41.53 5.02 41.62 7.02 >0.05
Left b-c 24.72 8.1 25.13 5.52 >0.05 23.13 8.57 25.7 7.16 <0.05*
Left c-d 36.48 10.7 35.18 6.47 >0.05 34.83 11.3 36.08 9.42 >0.05
Statistical analysis was done by t-test, Data expressed as mean and SD.
* P-value< 0.05 was considered as statistically significant.
In the present study in type 2 diabetes mellitus male
subjects,significantly decreased levels of right (38.32) and left (39.4)
a-b inter digital area ridge count was observed compared to normal
male subjects, right (41.08) and left (42.87).Significant increased
levels of right (26.62) and left (25.7) b-c inter digital area ridge count
in type 2 diabetes mellitus female subjects was observed compared
to normal female subjects, right (24.22) and left (23.13) respectively.
The present study coincides with the following Khan et al., (2013)
study in case of type 2 male diabetic patients.
Khan et al., (2013) have found that the mean a-b ridge count in
diabetics was significantly decreased (68.25) in comparison to non-
diabetics (70.80).
Right a-b
Right b-c
Right c-d
Left a-b
Left b-c
Left c-d
Inter digital areas ridge count between Type 2 Male diabetes mellitus
Pa
ram
ete
rs
Right a-b
Right b-c
Right c-d
Left a-b
Left b-c
Left c-d
Inter digital areas ridge count between Type 2 Female diabetes mellitus subjects
Pa
ram
ete
rs
Fig 17.
Fig 18.
87
26.16
36.62
24.72
36.48
25.01
35.96
25.13
35.18
Inter digital areas ridge count between Type 2 diabetes mellitus and Normal Male subjects
Male Type 2 DM
Mean
24.22
35.59
23.13
34.83
26.62
36.41
25.7
36.08
Inter digital areas ridge count between Type 2 diabetes mellitus and Normal Female
subjectsFemale Type 2 DM
Mean
41.08
36.62
42.87
36.48
38.32
35.96
39.4
35.18
Inter digital areas ridge count between Type 2 and Normal Male subjects
Normal Male
39.87
35.59
41.53
34.83
39.81
36.41
41.62
36.08
Inter digital areas ridge count between Type 2 and Normal Female
Female Type 2 DM
88
The present study coincides with the following Rakate et al., (2013)
study in case of type 2 female diabetic patients and differing in value
in case of type 2 male diabetic patients.
Rakate et al., (2013)found that the average a-b ridge count of male
diabetic patients had increased value of 36.00 on right hand and
37.00 on left hand compared to non-diabetic males 34.42 on right
hand and 35.44 on left hand.In females it was 34.66 on right hand,
35.33 on left hand which was adecreased value compared to non-
diabetic females 35.85 on right hand, 36.78 on left hand.
The present study coincides with the following Sharma et al., (2012)
study in case of type 2 female diabetic patients by showing
insignificant increase.
Sharma et al., (2012) have showed insignificant increase in mean
values for the a-b ridge count of the female diabetic patients.
Eberechi et al., (2012)have observed that there was significant
difference in the b-c palmar ridge count between the diabetic patients
and the essential hypertensive patients. b-c palmar ridge count in the
female essential hypertensive patients had a higher average value of
14.14 for the right hand and 14.34 for the left hand than in the
89
diabetic patients (13.50 for the right and 12.50 for the left hand),
(P<0.05).
Anju Bala et al., (2015) in observed the a-b ridge count in both hands
were higher in diabetic male and female except in the left hands of
male.Highly significant difference was found in both hands of female.
The present study coincides with the following Padmini et al., (2011)
study in case of type 2 female diabetic patients by showing
insignificant increase.
Padmini et al., (2011)reported that they observed decreased levels of
mean right a-b, left a-b ridge counts in female type 2 diabetes mellitus
patients compared to control females.
Table 12: Total finger ridge count between Type 2 Diabetes
mellitus and Normal subjects.
Parameter Male subjects Female Subjects
Type 2 DM Normal P value
Type 2 DM Normal P value Mean SD Mean SD Mean SD Mean SD
TFRC 145.1 42.2 153.4 46.9 >0.05 140.6 44.5 128 42.5 <0.05*
Statistical analysis was done by t-test, Data expressed as mean and SD.
* P-value< 0.05 was considered as statistically significant.
Decreased mean value of total finger ridge count in type 2 male
diabetes mellitus (145.14) was observed compared to total finger
90
ridge count in normal male subjects (153.42) which was statistically
insignificant.
Total finger ridge count in type 2 female diabetic shows that the mean
value was 140.58 compared to total finger ridge count in normal
female subjects shows that mean value was 127.54 which were
statistically significant with a 'p' value of < 0.05.
The present study coincides with the following Taiwo et al., (2012)
study in case of type 2 female diabetic patients by showing significant
increase.
Taiwo et al., (2012) have observed significant higher (P<0.05) total
finger ridge count in diabetic subjects than in non-diabetics.
Ravindranath et al., (1995) observed that the decrease in absolute
finger ridge count in male patients as compared with controls was
observed at p= 0.07 significant level. Burute et al., (2013) observed
that significantly lower level of total finger ridge count in diabetic
females than controls.
The present study coincides with the following Padmini et al., (2011)
study in case of type 2 female diabetic patients by showing significant
increase.
91
Padmini et al., (2011)observed an increase in means of total finger
ridge count (106.25), absolute finger ridge count (137.58) in male
diabetics than in controls with total finger ridge count (97.25), and
absolute finger ridge count (121.65). There was significant increase in
total finger ridge count (110.94), absolute finger ridge count (139.52)
in female diabetics than in controls with means of total finger ridge
count (110.94), and absolute finger ridge count (139.52).
Sengupta et al.,(1996) observed that the decreased level of mean
total finger ridge count in female (114.10) male (112.71) type 2
diabetic patients compared to normal male (149.40) and female
(133.32).
Table 13: Finger tip Ridge Counts between Type 2 Diabetes
mellitus and normal subjects.
Parameters Male subjects Female Subjects
Normal Type 2 DM P value
Normal Type 2 DM P value Mean SD Mean SD Mean SD Mean SD
Right thumb 19.11 6.44 17.56 5.86 >0.05 15.9 5.66 17.23 5.9 >0.05
Right index 13.41 6.34 12.76 6.33 >0.05 11.1 6.01 12.26 5.99 >0.05
Right middle 13.69 6.09 13.13 4.76 >0.05 12.21 5.39 13.67 5.33 >0.05
Right ring 17.09 5.56 16.17 5.32 >0.05 14.37 5.18 15.86 5.43 <0.05*
Right little 13.76 4.67 13.36 4.08 >0.05 11.42 4.83 12.6 4.66 > 0.05
Left thumb 18.29 6.44 15.65 5.66 <0.05* 14.09 6.32 15.94 5.35 <0.05*
Left index 12.06 7.16 12.12 6.37 >0.05 10.07 6.6 11.36 6.17 > 0.05
Left middle 13.86 6.08 13.54 6 >0.05 12.01 5.7 13.03 5.1 > 0.05
Left ring 17.74 6.37 16.68 5.94 >0.05 14.35 5.12 15.59 6.05 > 0.05
Left little 14.43 4.77 14.17 4.45 >0.05 12.02 4.74 13.03 5.23 > 0.05
Statistical analysis was done by t-test, Data expressed as mean and SD.
* P-value< 0.05 was considered as statistically significant.
92
19.11
13.41
13.69
17.09
13.76
18.29
12.06
13.86
17.74
14.43
17.56
12.76
13.13
16.17
13.36
15.65
12.12
13.54
16.68
14.17
Right thumb
Right index
Right middle
Right ring
Right little
Left thumb
Left index
Left middle
Left ring
Left little
Finger tip Ridge Count between Type 2 Male diabetes mellitus and normal Male subjects
Male Type 2 DM Normal Male
Pa
ram
ete
rs
Mean
15.9
11.1
12.21
14.37
11.42
14.09
10.07
12.01
14.35
12.02
17.23
12.26
13.67
15.86
12.6
15.94
11.36
13.03
15.59
13.03
Right thumb
Right index
Right middle
Right ring
Right little
Left thumb
Left index
Left middle
Left ring
Left little
Finger tip Ridge Count between Type 2 Female diabetes mellitus and normal Female subjects
Female Type 2 DM Normal Female
Pa
ram
ete
rs
Mean
Fig 19.
Fig 20.
93
Significant decrease levels of left thumb finger tip ridge count (15.65)
in Type 2 DM male subjects compared to normal male subjects
(18.29).The present study also found that increased level of mean
finger ridge count in right thumb, right index, right ring and left ring
fingers of male Type 2 diabetes mellitus compared to normal male.
These values were statistically insignificant.
Significant increase levels of right ring (15.86)and left thumb(15.94)
finger tip ridge count in type 2 female diabetes mellitus compared to
normal female subjects, right ring (14.37) and left thumb (14.09). The
present study also showed increased level of mean finger ridge count
in other fingers of both the hands of female type 2 diabetes mellitus
compared to normal female. These values were statistically
insignificant.
Karim et al., (2014) showed that the finger ridge count for each digit
of both hands of male patients and control group showed no
significant difference in all fingers of both hands except middle finger
of left hand that increased significantly (P<0.05). In case of finger
ridge count of female patients showed no significant difference in
most digits especially in left hand, index and little finger of right hand
showed significant increase (P<0.05) in finger ridge count when
compared with control groups.
94
The present study coincides with the following Anju Bala et al., (2016)
study in case of type 2 female diabetic patients by showing
insignificant values except male left thumb and female right ring and
left thumb.
Anju Balaet al., (2016)observed in male diabetic right hands, the
mean values of fingertip ridge counts were decreased in all digits
except in 2nd, 4th, and 5th digits than diabetic with hypertension
group. In left hands, the mean values of fingertip ridge counts were
decreased in all digits of diabetic group than diabetic with
hypertension group except in 2nd, 4th and 5th digits. No significant
difference in values was found.
In the following tabular columns the finger tip patterns of all the digits
in both the hands of type 2 diabetic patients and normal subjects
were recorded as the first of its kind in this research, since none of
the previous researchers had such an individual finger study to
compare with our study. Since no study was available similar to our
study in the literature, the results of the present study could not be
compared.
95
6.4. Qualitative dermatoglyphic pattern of Type 2 Diabetic patients. Table 14: Qualitative dermatoglyphic pattern of thumb of Type 2
Diabetes mellitus patients.
Patterns
Male Subjects Female Subjects Normal Type 2 DM Normal Type 2 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 41 44 53 60 55 43 62 59
TUL 0 4 0 2 1 1 0 0
Total 41 48 53 62 56 44 62 59
Radial loops
RL 0 0 0 0 1 1 0 1
TRL 0 0 0 0 0 1 0 0
Total 0 0 0 0 1 2 0 1
Whorls
DLW 15 28 12 24 14 27 9 17
SWCW 6 17 2 7 2 12 1 14
SWACW 22 0 23 1 16 0 17 1
CPUW 3 1 0 0 1 2 1 0
CPRW 4 0 1 2 0 3 1 4
LPULW 6 1 6 0 6 2 4 0
LPRLW 0 2 0 1 0 0 1 2
CW 1 0 0 0 0 0 0 0
ACC. W 0 0 0 0 0 0 0 0
Total 57 49 44 35 39 46 34 38
Arches A 2 0 3 3 4 8 4 2
TA 0 0 0 0 0 0 0 0
Total 2 0 3 3 4 8 4 2
Data expressed in percentage.
Increased percentage level of ulnar loops pattern in type 2
malediabetes mellitus patientswas observed in right thumb 53% and
left thumb 62%than normal male, right thumb 41% and left thumb
48%. Increased percentage level of ulnar loops pattern in type 2
female diabetes mellitus patients in right thumb 62% and left thumb
59% and female,right thumb 56% and left thumb 44%.
96
Decreased percentage level of whorls pattern in right and left thumb
was observed intype 2 male(right thumb 44% and left thumb 35%)
and female (right thumb 34% and left thumb 38%) diabetes mellitus
patients than normal male (right thumb 57% and left thumb 49%) and
female (right thumb 39% and left thumb 46%).
Decreased percentage level of left thumb arch pattern 3% was
observed in type 2 female diabetes mellitus patients than the normal
female, 0%.
Table 15: Qualitative dermatoglyphic pattern of index finger of
Type 2 Diabetes mellitus patients.
Patterns
Male subjects Female subjects
Normal Type 2 DM Normal Type 2 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 30 35 47 42 54 43 50 42
TUL 2 0 0 2 0 0 0 1
Total 32 35 47 44 54 43 50 43
Radial
loops
RL 7 4 4 8 5 9 3 6
TRL 1 0 1 1 2 2 1 0
Total 8 4 5 9 7 11 4 6
Whorls
DLW 6 9 3 7 6 5 3 7
SWCW 10 24 8 14 9 13 6 13
SWACW 16 0 13 3 5 0 14 1
CPUW 2 0 2 2 1 0 2 1
CPRW 10 10 10 8 4 10 7 12
LPULW 5 3 1 0 3 0 5 0
LPRLW 2 0 4 2 1 1 0 2
CW 0 0 0 0 0 0 0 0
ACC.W 1 0 0 0 0 0 0 0
Total 52 46 41 36 29 29 37 36
Arches
A 7 10 6 9 8 14 7 13
TA 1 5 1 2 2 3 2 2
Total 8 15 7 11 10 17 9 15
Data expressed in percentage.
97
Increased percentage level of ulnar loop pattern was observed in both
right (47%) and left(44%) index fingers in type 2 male diabetes
mellitus patients compared to normal males, right (32%) and
left(35%) index fingers. Decreased percentage level of radial loops
pattern in right index finger (5%) and increased percentage level of
same pattern in left index finger (9%) was observed in type 2 diabetic
male compared to normal male, right index (8%) and left index (4%)
fingers. Decreased percentage level of whorls pattern was observed
in both right (41%) and left(36%) index fingers in type 2 male diabetes
mellitus patients compared to normal malesright (52%) and
left(46%)index fingers. Decreased percentage level of arch pattern
was noted in both right (7%) and left (11%) index fingers of type 2
malediabetes mellitus patients compared to normal malesright (8%)
and left (15%) index fingers.
Decreased percentage level of ulnar loop pattern in right (50%)index
fingerwas observed intype 2femalediabetes mellitus patients
compared to normal females (54%). Decreased percentage level of
radial loops pattern in both right (4%) and left (6%) index fingers was
observed in type 2 diabetic female compared to normal female,right
(7%) and left (11%)index fingers. Increased percentage level of
whorls pattern in both right (37%) and left (36%) index fingerswas
98
observed in type 2femalediabetes mellitus patients compared to
normal females,right (29%) and left (29%)index fingers. Decreased
percentage level of arch pattern was noted in both right (9%) and left
(15%) index fingers of type 2 femalediabetes mellitus patients
compared to normal females, right (10%) and left (17%)index fingers.
Table 16: Qualitative dermatoglyphic pattern of middle finger of
Type 2 Diabetes mellitus patients.
Patterns
Male subjects Female subjects
Normal Type 2 DM Normal Type 2 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 58 51 71 68 78 69 77 71
TUL 4 3 1 0 0 2 2 0
Total 62 54 72 68 78 71 79 71
Radial
loops
RL 0 0 0 0 0 0 0 1
TRL 0 0 0 1 0 0 0 0
Total 0 0 0 1 0 0 0 1
Whorls
DLW 2 13 3 8 1 4 4 6
SWCW 3 16 2 12 2 11 0 8
SWACW 14 1 9 0 4 0 4 1
CPUW 8 0 6 0 4 1 7 2
CPRW 2 3 3 3 1 3 0 5
LPULW 0 2 4 0 4 2 1 0
LPRLW 2 2 0 0 0 0 0 0
CW 0 0 0 0 0 0 0 0
ACC.W 0 0 0 1 1 0 0 1
Total 31 37 27 24 17 21 16 23
Arches A 7 9 1 6 4 7 5 5
TA 0 0 0 1 1 1 0 0
Total 7 9 1 7 5 8 5 5
Data expressed in percentage.
Increased percentage level of ulnar loop pattern was observed in both
right (72%) and left(68%) middle fingers in type 2 male diabetes
mellitus patients compared to normal males, right (62%) and
left(54%) middle fingers. Decreased percentage level of whorls
99
pattern was observed in both right (27%) and left(24%) middle fingers
in type 2 male diabetes mellitus patients compared to normal males,
right (31%) and left(34%) middle fingers. Decreased percentage level
of arch pattern was noted in both right (1%) and left (7%) middle
fingers of type 2 malediabetes mellitus patients compared to normal
males (right (7%) and left (9%) middle fingers.No difference in the
percentage level of ulnar loops, radial loops, whorls and arches
pattern in both right and left middle fingerwas observed in type
2femalediabetes mellitus patients compared to normal females.
Table 17: Qualitative dermatoglyphic pattern of ring finger of
Type 2 Diabetes mellitus patients.
Patterns
Male subjects Female subjects
Normal Type 2 DM Normal Type 2 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 29 23 34 32 48 48 40 41
TUL 3 5 4 5 7 8 2 7
Total 32 28 38 37 55 56 42 48
Radial
loops
RL 0 0 0 1 0 1 0 0
TRL 0 0 0 0 0 0 0 0
Total 0 0 0 1 0 1 0 0
Whorls
DLW 0 3 1 0 1 2 1 2
SWCW 23 40 17 44 14 31 16 26
SWACW 16 1 11 1 5 3 4 7
CPUW 27 13 29 11 22 4 33 11
CPRW 0 1 0 2 1 1 1 0
LPULW 0 10 2 0 0 0 1 1
LPRLW 0 0 0 0 0 0 0 0
CW 0 1 0 1 0 0 0 1
ACC.W 0 0 1 0 1 1 0 0
Total 66 69 61 59 44 42 56 48
Arches
A 2 3 1 3 1 1 2 4
TA 0 0 0 0 0 0 0 0
Total 2 3 1 3 1 1 2 4
Data expressed in percentage.
100
Increased percentage level of ulnar loop pattern was observed in both
right (38%) and left(37%) ring fingers in type 2 male diabetes mellitus
patients compared to normal males, right (32%) and left(28%) ring
fingers. Decreased percentage level of whorls pattern was observed
in both right (61%) and left(59%) ring fingers in type 2 male diabetes
mellitus patients compared to normal males, right (66%) and
left(69%) ring fingers.
Decreased percentage level of ulnar loop pattern in both right (42%)
and left (48%) ring fingerswas observed in type 2femalediabetes
mellitus patients compared to normal females, right (55%) and left
(56%) ring fingers. Increased percentage level of whorls pattern in
both right (56%) and left (48%) ring fingerswas observed in type
2femalediabetes mellitus patients compared with normal females,
right ring finger (44%) and left ring finger (42%). In femaletype 2
diabetes mellitus patientsincreased percentage level of arch pattern
was noted in left ring (4%) finger compared to normal females (1%).
101
Table 18: Qualitative dermatoglyphic pattern of little finger of
Type 2 Diabetes mellitus patients.
Patterns
Male subjects Female subjects
Normal Type 2 DM Normal Type 2 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 64 63 74 73 75 71 78 72
TUL 4 6 5 7 2 3 2 0
Total 68 69 79 80 77 74 80 72
Radial
loops
RL 0 0 0 0 0 0 0 0
TRL 0 0 0 0 0 1 0 3
Total 0 0 0 0 0 1 0 0
Whorls
DLW 0 1 0 1 0 0 0 2
SWCW 3 18 3 11 4 13 3 14
SWACW 5 0 1 0 1 1 2 0
CPUW 21 6 17 2 15 3 12 3
CPRW 0 0 0 0 0 1 0 1
LPULW 3 6 0 6 3 5 1 2
LPRLW 0 0 0 0 0 0 0 0
CW 0 0 0 0 0 1 0 1
ACC.W 0 0 0 0 0 0 0 0
Total 32 31 21 20 23 24 18 23
Arches
A 0 0 0 0 0 1 2 2
TA 0 0 0 0 0 0 0 0
Total 0 0 0 0 0 1 2 2
Data expressed in percentage.
Increased percentage level of ulnar loop pattern was observed in both
right (79%) and left(80%) little fingers in type 2 male diabetes mellitus
patients compared to normal males, right (68%) and left(69%) little
fingers. Decreased percentage level of whorls pattern was observed
in both right (21%) and left (20%) little fingers in type 2 male diabetes
mellitus patients compared to normal males, right (32%) and left
(31%) little fingers.
102
Increased percentage level of ulnar loop pattern in right little (80%)
fingerwas observed in type 2femalediabetes mellitus patients
compared to normal females (77%).Intype 2femalediabetes mellitus
patientsdecreased percentage level of whorls pattern in both right
(18%) and left (23%) little fingerswas observed compared with normal
females, right (23%) and left (24%) little fingers. In femaletype 2
diabetes mellitus patientsincreased percentage level of arch pattern
was noted in right little finger (2%) compared with normal females,
right little finger (0%).
The following inferences were drawn after the analysis of the data of
the present study which involve large number of subjects.
In type 2 male diabetes mellitus patients increased percentage level
of following finger tip patterns facilitate in predicting diabetes mellitus
manifestation at a later stage.
� Thumb - Ulnar loopin left hand, 2. Index finger - Ulnar loop in
both right and left hands and arches in left hand, 3. Middle
finger - Ulnar loop in both right and left hands and arches in
right hand, 4. Little finger - Ulnar loop in both right and left
hands.
103
Ridge count parameters, significant values with which type 2 male
diabetes mellitus could be confirmed:
� Left a-b (p< 0.05), right a-b (p< 0.05) and left thumb (p< 0.05)
ridge count.
In type 2 female diabetes mellitus patients increased percentage level
of following finger tip patterns facilitate in predicting diabetes mellitus
manifestation at a later stage.
� Thumb - Ulnar loopin left hand, 2. Index finger - Ulnar loop in
left hand and whorls in right hand, 3. Middle finger - Ulnar loop
in left hand.
Ridge count parameters, significant values with which type 2 female
diabetes mellitus could be confirmed:
� Right b-c (p< 0.05), left b-c (p< 0.05), left thumb (p< 0.05) and
right ring (p< 0.05) finger ridge count.
Since no study was available similar to our study in the literature, the
results of the present study could not be compared.In the following
tabular columns quantitative and quantitative dermatoglyphic pattern
of type 1 with type 2 diabetic patients are recorded as the first of its
kind.
104
6.5. Quantitative dermatoglyphic pattern of Type 1 with Type 2
Diabetic patients.
Table 19: Total finger ridge count between Type 1 Diabetes
mellitus and Type 2Diabetes mellitus patients.
Parameter
Male subjects Female Subjects
Type 1 DM Type 2 DM P value
Type 1 DM Type 2 DM P Value
Mean SD Mean SD Mean SD Mean SD
TFRC 139.2 46 145.1 42.2 >0.05 135 45 140.6 44.5 > 0.05
Statistical analysis was done by t-test, Data expressed as mean and SD.
P-Value >0.05 was considered as statistically insignificant.
Increased mean value of total finger ridge count in type 2 male
diabetes mellitus (145.14) was observed compared to total finger
ridge count in type 1 male diabetes mellitus (139.18) which was
statistically insignificant.
Increased mean value of total finger ridge count in type 2 female
diabetes mellitus (140.6) was observed compared to total finger ridge
count in type 1 female diabetes mellitus (134.96) which was
statistically insignificant.
105
Table 20: Comparison of palmar Angles between Type 1
Diabetes mellitus and Type 2 Diabetes mellitus.
Parameters
Male Patients Female Patients
Type 1 DM Type 2 DM P value
Type 1 DM Type 2 DM P value Mean SD Mean SD Mean SD Mean SD
Right atd 42.9 4.98 43.2 7.8 >0.05 44.68 8.93 45.75 6.25 >0.05
Right dat 58.02 5.31 57.3 7.8 >0.05 53.52 9.3 56.7 5.73 <0.05*
Right tda 79.69 3.65 78.2 9.3 >0.05 77.98 11.8 78 4.16 >0.05
Left atd 44.53 5.01 43.4 6 >0.05 47.12 6.43 45.77 5.85 >0.05
Left dat 58.89 5.28 59.9 5.1 >0.05 56.36 5.68 57.89 5.88 >0.05
Left tda 77.08 3.97 76.4 5.5 >0.05 76.32 3.76 76.82 3.78 >0.05
Statistical analysis was done by t-test, Data expressed as mean and SD.
* P-value < 0.05 was considered as statistically significant.
The present study observed that an increased level of right atd
(43.21) and left dat (59.86) angles in type 2 male diabetes mellitus
patients compared to type 1 malediabetes mellituspatients, right atd
(42.9) and left dat (58.89) angles.
The present study also observed that an increased level of right dat
(58.02), right tda (79.69), left atd (44.53),and left tda (77.08) angles in
type 1malediabetes mellitus patients compared to type 2 male
diabetes mellitus patients, right dat (57.25), right tda (78.16), left atd
(43.38),and left tda (76.37) angles. These values were statistically
insignificant.
Significantly increased level of right dat (56.7) angles in type 2 female
diabetes mellitus patients compared to type 2femalediabetes mellitus
patients (53.52).
106
42.9
58.02
79.69
44.53
58.89
77.08
43.21
57.25
78.16
43.38
59.86
76.37
Right atd Right dat Right tda Left atd Left dat Left tda
Comparison of palmar angles between Type 1Male Diabetes Mellitus and Type 2 Male DiabetesMellitus
Male Type 1 DM Male Type 2 DM
Parameters
Me
an
44.68
53.52
77.98
47.12
56.36
76.32
45.75
56.7
78
45.77
57.89
76.82
Right atd Right dat Right tda Left atd Left dat Left tda
Comparison of palmar angles between Type 1Female diabetes mellitus and Type 2 Femalediabetes mellitus
Female Type 1 DM Female Type 2 DM
Parameters
Me
an
Fig 21.
Fig 22.
107
The present study also observed that an increased level of right atd
(45.75), right tda (78) and left dat (57.89) angles in type
2femalediabetes mellitus patients compared to type 1 femalediabetes
mellituspatients, right atd(44.68), right tda (77.98) and left dat (56.36)
angles. These values were statistically insignificant.
The present study observed that an increased level of left atd
(47.12)angle in type 1 female diabetes mellitus patients compared to
type 2 femalediabetes mellitus patients, left atd angles (45.77).
Table 21: Inter digital areas ridge count between Type 1 diabetes
mellitus and Type 2 diabetes mellitus.
Parameters
Male Patients Female Patients
Type 1 DM Type 2 DM P value
Type 1 DM Type 2 DM P value Mean SD Mean SD Mean SD Mean SD
Right a-b 41.5 5.3 38.32 6.55 <0.05* 42.66 5.54 39.8 4.95 <0.05*
Right b-c 24.48 8 25.01 6.39 >0.05 26.94 5.19 26.6 5.9 > 0.05
Right c-d 36.23 10 35.96 5.31 >0.05 38.66 6.72 36.4 7.57 > 0.05
Left a-b 42.66 4.99 39.4 5.43 <0.05* 44.3 6.69 41.6 7.02 <0.05*
Left b-c 23.3 8.85 25.13 5.52 >0.05 24.66 7.44 25.7 7.16 > 0.05
Left c-d 36.14 12.9 35.18 6.47 >0.05 38.78 9.33 36.1 9.42 > 0.05
Statistical analysis was done by t-test, Data expressed as mean and SD.
* P-value< 0.05 was considered as statistically significant.
Significantly increased levels of right (38.32) and left (39.4) a-b inter
digital areas ridge counts in male type 2 diabetes mellitus patients
compared to type 1 male diabetes mellitus patients, right (41.5) and
left (42.66).
108
41.5
24.48
36.23
42.66
23.3
36.14
38.32
25.01
35.96
39.4
25.13
35.18
Right a-b
Right b-c
Right c-d
Left a-b
Left b-c
Left c-d
Inter digital areas ridge count between Type 1Male Diabetes Mellitus patients and Type 2 MaleDiabetes Mellitus patients
Male Type 2 DM Male Type 1 DM
Pa
ram
ete
rs
Mean
42.66
26.94
38.66
44.3
24.66
38.78
39.81
26.62
36.41
41.62
25.7
36.08
Right a-b
Right b-c
Right c-d
Left a-b
Left b-c
Left c-d
Inter digital areas ridge count between Type 1 Female diabetes mellitus patients and Type 2 Female diabetes mellitus patients
Female Type 2 DM Female Type 1 DM
Pa
ram
ete
rs
Mean
Fig 23.
Fig 24.
109
Increasedlevels of right b-c (25.01) and left b-c (25.13) inter digital
areas ridge counts in type 2 male diabetes mellituspatients compared
to type 1 male patients,right b-c (24.48), and left b-c
(23.3).Increasedlevels of right c-d (36.23) and left c-d (36.14) inter
digital areas ridge counts in type 1 malediabetes mellitus patients
compared to type2 male patients, right c-d (35.96) and left c-d
(35.18). These values were statistically insignificant.
Significantly decreased levels of right (39.8) and left (41.6) a-b inter
digital areas ridge counts in type 2 female diabetes mellituspatients
compared to type 1 female diabetes mellituspatients,right (42.66)
and left (44.3).
Increasedlevels of right c-d (38.66) and left c-d (38.78) inter digital
areas ridge counts in type 1female diabetes mellitus patients
compared to type2female patients,right c-d (36.4) and left c-d
(36.1).Increasedlevels of left b-c (25.7) inter digital areas ridge counts
in type 2female diabetes mellitus patients compared to type 1female
patientsleft b-c (24.66).These values were statistically insignificant.
110
Table 22: Comparison of Finger tip Ridge Count between Type 1
Diabetes mellitus and Type 2 Diabetes mellitus patients.
Parameters Male subjects Female Subjects
Type 1 DM Type 2 DM P value
Type 1 DM Type 2 DM P value Mean SD Mean SD Mean SD Mean SD
Right thumb 13.72 5.16 17.56 5.86 >0.05 16.36 5.65 17.23 5.9 >0.05
Right index 11.32 6.27 12.76 6.33 >0.05 12.04 6.38 12.26 5.99 >0.05
Right middle 11.99 5.63 13.13 4.76 >0.05 12.34 5.08 13.67 5.33 >0.05
Right ring 15.21 5.2 16.17 5.32 >0.05 15.56 5.21 15.86 5.43 >0.05
Right little 13.03 4.86 13.36 4.08 >0.05 12.56 4.65 12.6 4.66 >0.05
Left thumb 16.15 5.39 15.65 5.66 >0.05 15.36 5.46 15.94 5.35 >0.05
Left index 11.21 6.65 12.12 6.37 >0.05 11.24 6.55 11.36 6.17 >0.05
Left middle 13.27 6.21 13.54 6 >0.05 12.38 6.6 13.03 5.1 >0.05
Left ring 15.45 6.39 16.68 5.94 >0.05 14.68 5.3 15.59 6.05 >0.05
Left little 13.72 4.86 14.17 4.45 >0.05 12.44 4.93 13.03 5.23 >0.05
Statistical analysis was done by t-test, Data expressed as mean and SD.
P-value> 0.05 was considered as statistically insignificant.
The present study observed that increased level of mean finger ridge
count in right thumb, right index, right middle, right ring, right little, left
index, left middle, left ring and left little fingers of male type 2 diabetes
mellitus compared to male type 1 diabetes mellitus. The present
study also observed that increased level of mean finger ridge count in
left thumb of male type 1 diabetes mellitus compared to male type 2
diabetes mellitus but these values were statistically insignificant.
The present study observed that increased level of mean finger ridge
count in right thumb, right middle, left middle, left ring and left little
fingers of female type 2 diabetes mellitus compared to female type 1
diabetes mellitus.Thesevalues were statistically insignificant.
111
17.83
11.32
11.99
15.21
13.03
16.15
11.21
13.27
15.45
13.72
17.56
12.76
13.13
16.17
13.36
15.65
12.12
13.54
16.68
14.17
Right thumb
Right index
Right middle
Right ring
Right little
Left thumb
Left index
Left middle
Left ring
Left little
Finger tip Ridge Count between Type 1 MaleDiabetes Mellitus and Type 2 Male DiabetesMellitus patients Male Type 2 DM
Pa
ram
ete
rs
Mean
16.36
12.04
12.34
15.56
12.56
15.36
11.24
12.38
14.68
12.44
17.23
12.26
13.67
15.86
12.6
15.94
11.36
13.03
15.59
13.03
Right thumb
Right index
Right middle
Right ring
Right little
Left thumb
Left index
Left middle
Left ring
Left little
Finger tip Ridge Count between Type 1 Femalediabetes mellitus and Type 2 Female diabetesmellitus patients
Female Type 2 DM Female Type 1 DM
Pa
ram
ete
rs
Mean
Fig 26.
Fig 25.
112
6.6. Qualitative dermatoglyphic pattern of Type 1 with Type 2
Diabetic patients.
Table 23: Qualitative dermatoglyphic pattern of thumb of Type 1
and Type 2 Diabetes mellitus patients.
Patterns
Male subjects Female subjects Type 1 DM Type 2 DM Type 1 DM Type 2 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 49 52 53 60 56 26 62 59%
TUL 2 0 0 2 2 0 0 0
Total 51 52 53 62 58 26 62 59
Radial
loops
RL 2 1 0 0 0 0 0 1
TRL 0 1 0 0 0 0 0 0
Total 2 2 0 0 0 0 0 1
Whorls
DLW 15 32 12 24 18 14 9 17
SWCW 5 10 2 7 4 7 1 14
SWACW 19 0 23 1 8 0 17 1
CPUW 2 0 0 0 0 0 1 0
CPRW 2 1 1 2 0 1 1 4
LPULW 3 1 6 0 6 0 4 0
LPRLW 0 1 0 1 2 1 1 2
CW 1 0 0 0 0 0 0 0
ACC. W 0 0 0 0 0 0 0 0
Total 47 45 44 35 38 23 34 38
Arches
A 0 1 3 3 4 1 4 2
TA 0 0 0 0 0 0 0 0
Total 0 1 3 3 4 1 4 2
Data expressed in percentage.
Increased percentage level of ulnar loops pattern in both right (53%)
and left (62%) thumb was observed in type 2 male diabetes mellitus
patients than type 1 male diabetes mellitus patients, right thumb 51%
and left thumb 52%.Increased percentage level of radial loop pattern
in both right (2%) and left (2%) thumb was observed in type 1 male
diabetes mellitus patients than type 2 male diabetes mellitus patients,
113
right thumb 0% and left thumb 0%.Decreased percentage level of
whorls pattern in both right (44%) and left (35%) thumb was found in
type 2 male diabetes mellitus patients than type 1 male diabetes
mellitus patients, right thumb 47% and left thumb 45%. Increased
percentage level of arches pattern in right (3%) and left (3%) thumb
was observed in type 2 male diabetes mellitus patients than type 1
male diabetes mellituspatients, right 0% and left 1%.
Increased percentage of ulnar loops pattern in right (62%) and left
(59%) thumb was observed in type 2 female diabetes mellitus
patients than type 1 female diabetes mellitus patients, right thumb
58% and left thumb 26%. Decreased percentage of whorls pattern in
right thumb (34%) and increased percentage level of whorls pattern in
right thumb (38%) was observed in type 2 female diabetes mellitus
patients than type 1 female diabetes mellitus patients, right thumb
38% and left thumb 23%.
114
Table 24: Qualitative dermatoglyphic pattern of index finger of
Type 1 and Type 2 Diabetes mellitus patients.
Patterns
Male subjects Female subjects Type 1 DM Type 2 DM Type 1 DM Type 2 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 40 33 47 42 58 36 50 42
TUL 1 2 0 2 4 0 0 1
Total 41 35 47 44 62 36 50 43
Radial
loops
RL 5 7 4 8 2 4 3 6
TRL 2 1 1 1 0 0 1 0
Total 7 8 5 9 2 4 4 6
Whorls
DLW 5 4 3 7 4 10 3 7
SWCW 4 15 8 14 8 8 6 13
SWACW 9 3 13 3 4 6 14 1
CPUW 3 2 2 2 2 2 2 1
CPRW 13 17 10 8 6 10 7 12
LPULW 4 0 1 0 0 4 5 0
LPRLW 2 3 4 2 2 4 0 2
CW 0 0 0 0 0 0 0 0
ACC.W 0 0 0 0 0 0 0 0
Total 40 44 41 36 26 44 37 36
Arches
A 10 1 6 9 8 12 7 13
TA 2 0 1 2 2 4 2 2
Total 12 1 7 11 10 16 9 15
Data expressed in percentage.
Increased percentage level of ulnar loop pattern was observed in both
right (47%) and left(44%) index fingers in type 2 male diabetes
mellitus patients compared to type 1 male diabetes mellitus patients,
right 41% and left 35% index fingers. In type 2 male diabetes mellitus
patients decreased percentage level of whorls pattern was observed
in leftindex finger (36%) compared with type 1 male diabetes mellitus
patients, left index finger (44%).Increased percentage level of arch
115
pattern was noted in left index (11%) finger of maletype 2 diabetes
mellitus patientsbut it was increased in right index (12%) finger of
type 1 male diabetes mellitus.
Decreased percentage level of ulnar loop pattern in right index (50%)
and increased percentage level of ulnar loop pattern in left index
(43%) fingerswas observed intype 2femalediabetes mellitus patients
compared to type 1femalediabetes mellitus patients, right index62%
and left index36% fingers. Increased percentage level of radial loops
pattern in both right (4%) and left (6%) index fingerswas observed in
type 2femalediabetes mellitus patients compared to type
1femalediabetes mellitus patients, right 2% and left 4%index fingers.
Increased percentage level of whorls pattern in right index (37%)
finger and decreased percentage level of whorls pattern in left index
(36%) fingerwas observed in type 2femalediabetes mellitus patients
compared to type 1femalediabetes mellitus patients, right 26% and
left 44% index fingers.
116
Table 25: Qualitative dermatoglyphic pattern of middle finger of
Type 1 and Type 2 Diabetes mellitus patients.
Patterns
Male subjects Female subjects Type 1 DM Type 2 DM Type 1 DM Type 2 DM
Right Left Right Left Righ
t Left Right Left
Ulnar Loops
UL 68 61 71 68 82 60 77 71
TUL 0 2 1 0 0 2 2 0
Total 68 63 72 68 82 62 79 71
Radial
loops
RL 0 1 0 0 0 0 0 1
TRL 0 0 0 1 0 2 0 0
Total 0 1 0 1 0 2 0 1
Whorls
DLW 2 10 3 8 2 10 4 6
SWCW 5 12 2 12 0 10 0 8
SWACW 11 0 9 0 10 2 4 1
CPUW 0 2 6 0 2 0 7 2
CPRW 1 2 3 3 0 2 0 5
LPULW 4 0 4 0 0 0 1 0
LPRLW 0 2 0 0 0 0 0 0
CW 0 0 0 0 0 0 0 0
ACC.W 1 0 0 1 0 0 0 1
Total 24 28 27 24 14 24 16 23
Arches
A 7 7 1 6 4 10 5 5
TA 1 1 0 1 0 2 0 0
Total 8 8 1 7 4 12 5 5
Data expressed in percentage.
Increased percentage level of ulnar loop pattern was observed in both
right (72%) and left(68%) middle fingers in type 2 male diabetes
mellitus patients compared to type 1 male diabetes mellitus patients,
right 68% and left 63% middle fingers. Increased percentage level of
whorls pattern in right middle finger (27%) and decreased percentage
level of same pattern in left middle finger (24%) was observed in type
2 male diabetes mellitus patients compared to type 1 male diabetes
mellitus patients, right 24% and left 28% middle fingers.Decreased
117
percentage level of arch pattern was noted in right middle finger (1%)
of maletype 2 diabetes mellitus patientsbut it was increased in left
middle finger (8%) of type 1 male diabetes mellitus patients.
Decreased percentage level of ulnar loop pattern in right (79%)
middle and increased percentage level of ulnar loop pattern in left
middle (71%) fingerswas observed intype 2femalediabetes mellitus
patients compared to type 1femalediabetes mellitus patients, right
82% and left 62% middle fingers. Increased percentage level of
whorls pattern in right middle finger (16%) and decreased percentage
level of whorls pattern in left middle finger (23%)was observed in type
2femalediabetes mellitus patients compared to type 1femalediabetes
mellitus patients, right 14% and left 24% middle fingers. Decreased
percentage level of arch pattern was noted in left middle (5%) finger
of maletype 2 diabetes mellitus patients compared totype 1 male
diabetes mellitus patients (12%).
118
Table 26: Qualitative dermatoglyphic pattern of ring finger of
Type 1 and Type 2 Diabetes mellitus patients.
Patterns
Male subjects Female subjects Type 1 DM Type 2 DM Type 1 DM Type 2 DM
Right Left Right Left Right Left Right Left
Ulnar loops
UL 28 33 34 32 38 30 40 41
TUL 7 10 4 5 4 12 2 7
Total 35 43 38 37 42 42 42 48
Radial
loops
RL 0 0 0 1 0 2 0 0
TRL 0 0 0 0 0 0 0 0
Total 0 0 0 1 0 2 0 0
Whorls
DLW 1 1 1 0 2 2 1 2
SWCW 11 34 17 44 10 32 16 26
SWACW 8 1 11 1 14 4 4 7
CPUW 41 11 29 11 28 12 33 11
CPRW 0 3 0 2 0 2 1 0
LPULW 1 5 2 0 4 0 1 1
LPRLW 0 0 0 0 0 0 0 0
CW 2 0 0 1 0 0 0 1
ACC.W 1 1 1 0 0 2 0 0
Total 65 56 61 59 58 54 56 48
Arches
A 0 1 1 3 0 2 2 4
TA 0 0 0 0 0 0 0 0
Total 0 1 1 3 0 2 2 4
Data expressed in percentage.
Increased percentage level of ulnar loop pattern in right ring finger
(38%) and decreased percentage level of ulnar loop pattern in leftring
finger (37%) was observed in type 2 male diabetes mellitus patients
compared to type 1 male diabetes mellitus patients, right 35% and left
43%ring fingers. Decreased percentage level of whorls pattern in right
ring finger (61%) and increased percentage level of whorlspattern in
left ring finger (59%) was observed in type 2 male diabetes mellitus
119
patients compared to type 1 male diabetes mellitus patients, right
65% and left 66%ring fingers.Increased percentage level of arch
pattern was noted in both right (1%) and left (3%) ring fingers was
noted in type 2 male diabetes mellitus patients compared to type 1
male diabetes mellitus patients, right 0% and left 1%ring fingers.
Increased percentage level of ulnar loop pattern in left ring finger
(48%) was observed in type 2femalediabetes mellitus patients
compared to type 1femalediabetes mellitus patients (42%).
Decreased percentage level of whorls pattern in both right (56%) and
left (48%) ring fingerswas observed in type 2femalediabetes mellitus
patients compared to type 1femalediabetes mellitus patients, right
58% and left 54%ring fingers. Increased percentage level of arch
pattern in both right (2%) and left (4%) ring fingers was noted in type
2 female diabetes mellitus patients compared to type 1 female
diabetes mellitus patients, right 0% and left 2%ring fingers.
120
Table 27: Qualitative dermatoglyphic pattern of little finger of
Type 1 and Type 2 Diabetes mellitus patients.
Patterns
Male subjects Female subjects Type 1 DM Type 2 DM Type 1 DM Type 2 DM
Right Left Right Left Right Left Right Left
Ulnar Loops
UL 62 68 74 73 78 64 78 72
TUL 7 4 5 7 4 4 2 0
Total 69 72 79 80 82 68 80 72
Radial
Loops
RL 0 0 0 0 0 0 0 0
TRL 0 0 0 0 0 0 0 3
Total 0 0 0 0 0 0 0 3
Whorls
DLW 0 0 0 1 0 0 0 2
SWCW 2 17 3 11 2 24 3 14
SWACW 4 0 1 0 2 0 2 0
CPUW 21 3 17 2 12 2 12 3
CPRW 0 0 0 0 0 0 0 1
LPULW 4 6 0 6 2 4 1 2
LPRLW 0 0 0 0 0 0 0 0
CW 0 0 0 0 0 0 0 1
ACC.W 0 1 0 0 0 0 0 0
Total 31 27 21 20 18 30 18 23
Arches
A 0 1 0 0 0 2 2 2
TA 0 0 0 0 0 0 0 0
Total 0 1 0 0 0 2 2 2
Data expressed in percentage.
Increased percentage level of ulnar loop pattern in both right (79%)
and left little (80%) fingers was observed in type 2 male diabetes
mellitus patients compared to type 1 male diabetes mellitus patients,
right 69% and left 72%. Decreased percentage level of whorls pattern
in right (21%) and left (20%) little fingers was observed in type 2 male
diabetes mellitus patients compared to type 1 male diabetes mellitus
patients, right 31% and left 27% little fingers.
121
Increased percentage level of ulnar loop pattern in both right (80%)
and left (72%) little fingers was observed in type 2femalediabetes
mellitus patients compared to type 1femalediabetes mellitus patients,
right 82% and left 68% little fingers. Decreased percentage level of
whorls pattern in left little finger(23%) was observed in type
2femalediabetes mellitus patients compared to type 1femalediabetes
mellitus patients (30%). Increased percentage level of arch pattern in
right little finger (2%) was noted in type 2 female diabetes mellitus
patients compared to type 1 female diabetes mellitus patients (0%).
The results of qualitative and quantitative comparison of type 1 and
type 2 male diabetes mellitus patients:
� Increased right a-b (p< 0.05), left a-b (p< 0.05)inter digital areas
ridge count in type 1 male diabetes mellituspatients and
decreased in type 2 male diabetes mellitus patients.
In type 2 male diabetes mellitus patients increased percentage level
of following finger tip patterns compared to type 1 male diabetes
mellitus patients facilitate in prediction of diabetes mellitus
manifestation at a later stage.
� Thumb - Ulnar loopin left hand, 2. Index finger - Ulnar loop in
both right and left hands and archesin left hand, 3. Middle finger
122
-Ulnar loop in both right and left handsand arches in right hand,
4. Little finger - Ulnar loop in both right and left hands.
The results of qualitative and quantitative comparison of type 1 and
type 2 female diabetes mellitus patients:
� Increased right a-b (p< 0.05), left a-b (p< 0.05) ridge count in
type 1 female diabetes mellitus patients and decreased in type
2 female diabetes mellitus patients.
� Decreased right tad (p< 0.05) angle in type 1 femalediabetes
mellitus patients and increased in type 2 femalediabetes
mellitus patients.
In type 2 female diabetes mellitus patients increased percentage level
of following finger tip patterns compared to type 1 female diabetes
mellitus patients facilitate in prediction of diabetes mellitus
manifestation at a later stage.
� Thumb - Ulnar loopin left hand, 2. Index finger - Ulnar loop in
left hand and whorls in right hand, 3. Middle finger - Ulnar loop
in left hand.
Since the subjects undertaken for our study were proved, registered
diabetics and taking treatment for diabetes, the above significant
criteria may be taken as a tool for predicting diabetes in future.
123
Dermatoglyphic knowledge acquired from the above mentioned
features are suitable, economical and easydiagnostic tool for
predicting type 1 and type 2 diabetes mellitus. Our current work
emphasizes and proves that dermatoglyphic study will predict the
future onset of diabetes mellitus by creating an awareness and
warning in the population and decrease the morbidity and mortality of
diabetes mellitus patients.
124
7. CONCLUSION
1. Compared to normal male subjects quantitativelyfinger tip ridge
count of right index finger, right middle finger,right ring finger, left
thumb and left ring fingers in type 1 male patients were found to be
decreased. Compared to normal female subjects increased levels
of left atd angles, right and left a-b, c-d and right b-c ridge counts
in female type 1 diabetes mellitus patients.The above quantitative
values facilitate in early prediction of diabetes mellitus
manifestation at a later stage.
2. Type 1 male diabetes mellitus patients showed increased
percentage levels of ulnar loop finger tip pattern in both left and
right hands of thumb, middle finger, ring finger, little finger and
right index finger except left index finger, radial loop finger tip
pattern in left index finger, compared to normal male subjects,
which facilitates in early prediction of diabetes mellitus
manifestation.
Type 1 female diabetes mellitus patients showed increased
percentage levels of ulnar loop finger tip pattern in both left and
right hands of thumb, right index finger, right middle finger and
right little finger, whorls finger tip pattern in left index finger, middle
finger, ring finger, little finger and only in right ring finger,arches
125
finger tip pattern only in left middle finger, compared to normal
female subjects, which facilitates in early prediction of diabetes
mellitus.
3. Quantitative observations on right and left a-b inter digital area and
left thumb finger tip ridge counts were found to be decreased in
male type 2 diabetes mellitus patients. Quantitative observation on
right and left b-c inter digital area, right ring and left thumb finger
tip ridge counts were increased in type 2 female diabetes
mellituspatients. The above quantitative values facilitate in early
prediction of diabetes mellitus.
4. Qualitative ulnar loops pattern of index, middle, ring and little
fingers in both right and left hands of type 2 male and female
diabetes mellitus patients was found to be increased compared to
the normal males and females except thumb. Whorls pattern of
right hand index finger of type 2 female diabetes mellitus patients
has increased than the normal females. Arches pattern of left hand
index finger and right hand middle finger of type 2 male diabetes
mellitus patients has increased than the normal males. The above
qualitative values facilitate in early prediction of diabetes mellitus
manifestation at a later stage.
126
5. Quantitativelyright tad angles in female type 2 diabetes mellitus
patients were seen to be increased compared to type 1 diabetes
mellitus female patients. Increased levels of right and left a-b inter
digital areas ridge counts in male type 2 diabetes mellitus patients
were noted, compared to type 1 male patients. The above two
increased criteria facilitate in early prediction of diabetes mellitus
manifestation at a later stage.
6. Type 2 male diabetes mellitus patients showed increased
percentage levels of ulnar loopfinger tip patternin both left and right
hands of index finger, middle finger, little finger and left thumb
except right thumb, arches finger tip pattern in left hand index
finger and right hand middle finger,compared to type 1 male
diabetes mellitus,which facilitates in early predictionof diabetes
mellitus manifestation at a later stage.
Type 2 female diabetes mellitus patients showed increased
percentage levels of ulnar loopfinger tip patternin left hand of
thumb, index finger, middle finger, whorls finger tip pattern in right
hand index finger, compared to type 1 female diabetes mellitus,
which facilitates in early predictionof diabetes mellitus
manifestation at a later stage.
127
8. SUMMARY
Dermatoglyphics isthe technique of the study of ridgespatterns on the
skin of the fingers, palms, toes and soles. The present study is
focused on the quantitative and qualitative dermatoglyphic features of
type 1 and type 2 diabetes mellitus patients. It will be possible
topredict the susceptibility of an individual to diabetes by using these
characteristics. Predicting the onset of diabetes mellitus by
dermatoglyphics will contribute significantly to the decrease in the
morbidity and mortality of diabetes mellitus. Numerous studies have
been carried out to link the dermatoglyphicpatterns with onset of type
1 and type 2 diabetes mellitus.
There is a paucity of dermatoglyphic studies on diabeticpatients in
and around Salem district of Tamil Nadu. Patients diagnosed with
type 1 and type 2 diabetes mellitus attending the diabetic clinic
attached to Vinayaka Missions University hospitals and other local
Government and private hospitals, Salem were used for this study.
The results of the present study showed that infemale type 1 diabetes
mellitus patientssignificantly decreased levels of right dat (53.52) and
left dat (56.36) angles compared to normal female subjects, right
datangle (57.55) and left dat angles (58.77). In female type 1 diabetes
128
mellitus patients significantly increased level of left atd angle (47.12)
compared to normal female subjects (44.83) are positive signs for
predicting type 1 and type 2 diabetes mellitus.The current work
demonstrates that the atd angle, dat angle, a-b and b-c ridge
countscan be used as reliable indicators for scientific screening of
populations prone to become diabetes mellitus patients.
Quantitative observations of finger tip ridge count ofmale type 1
diabeticpatients were decreased and increased levels of left atd
angles, right and left a-b, c-d and right b-c ridge counts in female type
1 diabetes mellitus patients were present, compared to normal
subjects.Type 1 male diabetes mellitus patientsshowed increased
percentage levels of ulnar loop finger tip pattern in both left and right
hands. Type 1female diabetes mellitus patients showed increased
percentage levels of ulnar loop finger tip pattern in both left and right
hands compared to normal subjects.
Quantitative observations on right and left b-c inter digital area, right
ring and left thumb finger tip ridge counts were increased in type 2
female diabetes mellituspatients. Whorls pattern of right hand index
finger of type 2 female diabetes mellitus patients has increased than
the normal females. Arches pattern of left hand index finger and right
129
hand middle finger of type 2 male diabetes mellitus patients has
increased than the normal males. Type 2 male diabetes mellitus
patients showed increased percentage levels of ulnar loopfinger tip
patternin both left and right hands,arches finger tip pattern in left hand
index finger and right hand middle finger, compared to type 1 male
diabetes mellitus.
Type 2 female diabetes mellitus patients showed increased
percentage levels of ulnar loopfinger tip patternin left hand whorls
finger tip pattern in right hand index finger, compared to type 1 female
diabetes mellitus.
From the present study it appears that dermatoglyphics has scope to
be used as suitable method for diabetes type 1 and type 2
studies.The dermatoglyphicscan be used as a diagnostic toolfor
predicting the development of diabetes at a later date is emphasized
by the results of the present research work.Though extensive
research work has been carried out regarding dermatoglyphics and
diabetes mellitus independently, combined study correlating the two
entities are few. So, to bring forth correlation between
dermatoglyphics and type 1 and type 2 diabetes mellitus and to
evaluate their significance, present study had been carried out.
130
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PUBLICATIONS FROM THE Ph. D THESIS
1. Perumal A, Manjunath KY. A study on inter digital area ridge count
in type 2 diabetes mellitus. Int J Res Rev. 2016; 3(3): 21-24.
2. Perumal A, Manjunath KY, Yuvaraj MG, Srinivasan KR.
Dermatoglyphic study of fingertip patterns in type 2 diabetes
mellitus. Int J Res Rev. 2016; 3(3): 61-68.
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PATIENT PROFORMA Date:........................
1. Name:...............................................................................................................................
2. Age:..................................................................................................................................
3. Sex:...................................................................................................................................
4. Diabetic / not Diabetic. If diabetic since how many years suffering from
Diabetics?..........................................................,,.............................................................
5. Blood glucose levels: R:.............F:...............PP:................HB1AC:..............GTT:...............
6. Family history of Diabetes................................................................................................
7. Treatment taking or not, if there is treatment, which type of
treatment?............................................................................................................................
8. Duration of treatment: ....................................................................................................
9. Life Style: (a). Are you smoker? If smoker, then duration...............................................
(b). Are you alcoholic? If alcoholic, chronic/ occasional.................................
(c). occupation:...............................................................................................
(d). Physical exercise:......................................................................................
10. Food habit:......................................................................................................................
11. Weather he/ she has any other medical problem like....................................................
(a). Hypertension:.......................................................................................................
(b). Any renal problem:...............................................................................................
(c). Hypo/hyperthyroidism:.........................................................................................
(d). Dyslipidemia:.........................................................................................................
(e). Cardiac problem:...................................................................................................
(f). Peripheral vascular disorder:.................................................................................
(g). Peripheral neuropathy:.........................................................................................
(h). Visual problem:.....................................................................................................
(i). Recurrent skin infections:......................................................................................
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