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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