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Diabetes And Hands

Hand And Wrist Conditions

Hand And Wrist Conditions

Tweet A number of joint disorders affecting the hands exist which have a link with diabetes. Unlike diabetes related conditions of the foot, diabetic hand problems are generally less serious and hand amputation is unlikely. However, it pays to be aware of the conditions to be able to treat them before they develop and cause pain, discomfort or limited mobility. Diabetic hand syndrome (cheiroarthropathy) Diabetic hand syndrome, also known as stiff hand syndrome and by its formal name cheiroarthropathy, is characterised by an inability to straighten joints in the hand. A typical diagnostic technique is to hold one’s hands together, palm to palm, in the ‘prayer position’. Those who cannot touch each of the joints of each hand together may have diabetic hand syndrome. Treatments may include stretching or strengthening exercises of the hand. Dupuytren's contracture Dupuytren's contracture, like diabetic hand syndrome, also prevents the fingers (often one finger) being fully extended. Most often it is the fourth and fifth fingers that are affected. Dupuytren's contracture is a result of small lumps or nodules on connective tissue of the palm of the hand causing the tissue to gradually shorten over time. Treatment will usually involve surgery which, in less serious cases, should allow full functioning of the affected finger afterwards. Tenosynovitis (trigger finger) Tenosynovitis affects the tendons and is most prevalent in the hand and wrist. The tendons move through a tunnel of tissue and when the tendons get inflamed they can start to catch on the inside of their tunnel causing which prevents the fingers, for instance, moving smoothly and can cause the finger to lock into one position. If the tendons repeatedly catch like this it can cause them to become more inflamed Continue reading >>

Hand & Arm Complications

Hand & Arm Complications

Chronically elevated blood sugars can damage the upper extremities. Hand and arm (upper extremity) complications include nerve damage and tissue damage from chronically elevated blood sugars. Hand complications Neuropathy Symptoms are tingling, pain and/or numbness in the fingers and hands. Less commonly, there can be muscle weakness and loss. Carpal tunnel or ulnar tunnel nerve entrapment syndrome: Nerves can get pinched by soft tissue buildup in the nerve tunnels in the wrist (carpal tunnel) and elbow (ulnar tunnel). This pressure on the nerves leads to pain, tingling, numbness and sometimes even muscle wasting. Dupuytren’s contracture This is a shortening of tendons in the palm of the hand that bends the fingers and keeps them from being straightened. Trigger finger In this condition, a nodule on the tendon gets caught and keeps the finger from fully straightening. Shoulder complications Frozen shoulder Buildup of connective tissue causes adhesions in the shoulder joint space. This restricts arm movement and can be very painful. Self-assessment Quiz Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Diabetes Complications, take our self assessment quiz when you have completed this section. The quiz is multiple choice. Please choose the single best answer to each question. At the end of the quiz, your score will display. If your score is over 70% correct, you are doing very well. If your score is less than 70%, you can return to this section and review the information. Continue reading >>

Symptoms Of Diabetes

Symptoms Of Diabetes

It is possible to have diabetes with only very mild symptoms or without developing any symptoms at all. Such cases can leave some people with diabetes unaware of the condition and undiagnosed. This happens in around half of people with type 2 diabetes.1,2 A condition known as prediabetes that often leads to type 2 diabetes also produces no symptoms. Type 2 diabetes and its symptoms develop slowly.3 Type 1 diabetes can go unnoticed but is less likely to do so. Some of its symptoms listed below can come on abruptly and be accompanied by nausea, vomiting or stomach pains.2-4 It is important to see a doctor if there is any suspicion of diabetes or if any of the below signs and symptoms are present - prompt diagnosis and management lowers the likelihood of serious complications.5 The most common symptoms are related to hyperglycemia (high blood sugar levels), especially the classic symptoms of diabetes: frequent urination and thirst. Fatigue related to dehydration and eating problems can also be related to high blood sugars.5,6 The International Diabetes Foundation highlight four symptoms that should prompt someone to get checked for diabetes as soon as possible:1 Common symptoms of diabetes The most common signs and symptoms of diabetes are: Frequent urination Have you been going to the bathroom to urinate more often recently? Do you notice that you spend most of the day going to the toilet? When there is too much glucose (sugar) in your blood you will urinate more often. If your insulin is ineffective, or not there at all, your kidneys cannot filter the glucose back into the blood. The kidneys will take water from your blood in order to dilute the glucose - which in turn fills up your bladder. Disproportionate thirst If you are urinating more than usual, you will need to r Continue reading >>

What Is Diabetic Hand Syndrome?

What Is Diabetic Hand Syndrome?

I fielded a question earlier this week on my Facebook page in regards to a fellow type 1 diabetic having diabetic hand pain and issues with their hands being stiff and they seemed harder to move. Immediately carpal tunnel syndrome popped into my head, but after she brought this up to her doctor and they ruled out carpal tunnel, they moved on to another diagnosis. A condition called diabetic hand syndrome (DHS). Honestly, I’ve never heard of DHS but like most things that grab my attention and not knowing much about something, I decided to see what this was all about. So what is DHS? Let’s take a closer look! What Is Diabetic Stiff Hand Syndrome? So here we are, diabetic hand syndrome or as its more formerly know as, stiff hand syndrome or cheiroarthropathy. Stiff hand syndrome is one of the most common hand disorders for people with diabetes. Another common nerve and joint problem is Carpal Tunnel Syndrome (CTS). Granted carpal tunnel is not caused by diabetes, but happens more often to people with diabetes, especially those who have diabetic neuropathy. Diabetic Hand Syndrome Symptoms Stiff Hand Syndrome is painless and can effect both type 1 and type 2 diabetics. It usually begins in your little finger. Then it spreads over time to your thumb. This stiffness then keeps you from being able to straighten your fingers fully. In addition, the skin on the back of your hand may also become thick, tight and waxy-looking. One way to tell if you have Stiff Hand Syndrome is to hold the palms of your hands together as if you are praying. If all of the skin and joints of your palms and fingers don’t touch, there is the possibility that you may have stiff hand Syndrome. What Causes Diabetes Hand Syndrome While it’s not fully known, doctors believe that multiple factors are Continue reading >>

Peripheral Neuropathy And Diabetes

Peripheral Neuropathy And Diabetes

Pain. Tingling. Numbness. If you have a type of nerve damage from diabetes called diabetic peripheral neuropathy, chances are you've experienced these symptoms, especially in your hands and feet. The discomfort can affect your mood, sleep, and overall quality of life. Prescription medications can help. But research shows that they only ease the pain by about 30% to 50%. How can you bridge the gap? Learn how you can get relief now -- and prevent the condition from getting worse down the road. If don't manage your diabetes, your blood glucose levels get too high. Over time, excess blood sugar can damage your peripheral nerves. These connect your brain and spinal cord to the rest of your body. That could set the stage for diabetic neuropathy. If you bring your blood sugar into the healthy range (a hemoglobin A1C reading of 7% or lower), you'll reduce your risk of nerve damage by 60%, according to research from the National Institute of Diabetes and Digestive and Kidney Diseases. "Healthy blood sugar levels can slow the process and ease the pain of diabetic neuropathy," says Aaron I. Vinik, MD, PhD, the director of the research and neuroendocrine unit at Eastern Virginia Medical School. How can you keep your blood sugar in check? First, talk to your doctor. "A rapid drop can actually make the pain worse," Vinik says. Your doctor can suggest changes to gently bring your levels down into the healthy zone, like: Eat a diet high that's in fruits, vegetables, low-fat dairy, and whole grains; contains a moderate amount of fish, poultry, nuts, and beans; and has a very low amount of red meat. Manage your stress levels. Exercise for at least 30 minutes, 5 days a week. If your doctor prescribes medication for your blood sugar, take it as recommended. Acetaminophen, aspirin, ibuprofe Continue reading >>

Diabetes And Cracked Fingertips: Everyone's Hands Need Help

Diabetes And Cracked Fingertips: Everyone's Hands Need Help

People with diabetes are like everyone else, only more so. This realization has been slowly growing in my mind as I began to appreciate that while we talk all the time about how those of us with diabetes need regular exercise, good nutrition, and weight control, everyone needs that too. Even the complications of diabetes are more intense manifestations of what anyone may experience. For example, the problems that we often experience with our skin are similar to what just about everyone experiences, although maybe we experience them more often or more severely. High blood glucose levels can sure make wound control more difficult. But I know from my own experience that even as I have controlled my blood glucose, my hands can get just as dry and cracked as they ever were. Maybe more so. Maybe it’s the typical dryness of winter. Maybe it’s the special dryness where I have lived for the past three or four years. Maybe it’s because I’m more active outside now. But it’s certain that my hands need help. And everyone’s hands need help. My dermatologist, Yan Isabel Zhu, emphasized that to me last month when she checked me for skin cancer, as she does at least once a year. “We all need to apply a thin layer of hand and skin cream every time we wash our hands,” she told me during a recent check up. “In all seasons and in every part of the country.” Applying hand and skin cream every time I wash my hands has been a challenge. I’ve been a good boy. I wash my hands regularly – including every time I go to the bathroom or come into my place from outside. That avoids a lot of problems. But it causes problems too. My hands get awfully dry and cracks often develop. Apparently these “split fingertips” are an awfully common problem among people with and without d Continue reading >>

Diabetes Hands Foundation Closes, Handing Diabetes Forums To Beyond Type 1

Diabetes Hands Foundation Closes, Handing Diabetes Forums To Beyond Type 1

On June 8th, the Diabetes Hands Foundation (DHF) announced the winding down of the organization, after having served the diabetes community for nearly 10 years. Beyond Type 1, a global non-profit organization focusing on education, advocacy, and a cure for Type 1 diabetes, has been selected to take over and continue the work of DHF’s diabetes forums, TuDiabetes and EsTuDiabetes. The transition is likely to begin this week, with Mila Ferrer joining Beyond Type 1 from DHF. Ferrer will continue to serve as program director. As Beyond Type 1 is taking over only DHF’s forums, the transition means that the MasterLab, the Big Blue Test, and Diabetes Advocates programs will likely be discontinued. It appears that funding was one of the reasons why DHF decided to fold, and we know all too well what a challenge it can be to maintain sustainable funding. A DiabetesMine article noted, “There have been rumblings about sponsorship and funding challenges for the non-profit for the past several years, especially after founder Manny Hernandez departed…” According to the Beyond Type 1 press release, “The Diabetes Hands Foundation has been a pioneering force for the entire diabetes community since 2008, uniting efforts across Type 1 and Type 2 diabetes, as well as across languages and backgrounds. While Diabetes Hands Foundation will shut down, the two communities that DHF runs – TuDiabetes.org (English) and EsTuDiabetes.org (Spanish) – are critical and must be maintained.” Thom Sher, Beyond Type 1’s Chief Operations Officer, expressed the organization’s commitment to maintaining and continuing to provide the forums as a space to connect about diabetes. “Based on the userbase data that I reviewed, the communities appear to be vibrant, and the message boards are key Continue reading >>

How To Deal With Nerve Pain If You Have Diabetes

How To Deal With Nerve Pain If You Have Diabetes

If you have diabetes , you know it well: Too much sugar isn’t good for you. People whose blood sugar is too high or difficult to control are more susceptible to cardiovascular disease, kidney damage, eye problems and other complications, including nerve damage (diabetic neuropathy). Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy “High blood sugar is toxic to your nerves,” says  Robert Bolash, MD , a specialist in Cleveland Clinic’s Department of Pain Management. “When a nerve is damaged, you may feel tingling, pins and needles, burning or sharp, stabbing pain.” Diabetic neuropathy typically starts in your toes, feet or ankles and creeps up your body as the condition worsens, he says. However, nerve damage also can affect your hands and wrists as well as your heart, digestive system, sex organs and more. Up to 70 percent of people with diabetes have some kind of neuropathy , reports the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) . “Anyone with diabetes can get nerve damage at any time,” says Dr. Bolash. “It’s most common in people whose blood sugar is poorly controlled and those who have had diabetes a long time.” According to the NIDDK, the highest rates of neuropathy are among people who have had diabetes 25 years or longer. To avoid getting diabetic neuropathy, control your blood sugar, keeping it as close to nondiabetic levels as possible, advises Dr. Bolash. The bad news about diabetic neuropathy is that it’s tough to reverse. It also can cause serious problems, especially in your feet. If you don’t feel blisters, sores or other foot injuries and don’t promptly care for them, you Continue reading >>

Diabetes And Your Hands

Diabetes And Your Hands

Did you know that diabetes can hurt, stiffen, and even disable your shoulders, wrists, fingers, and other joints? None of these conditions is well understood. So how can you prevent them and deal with them? Of course, people without diabetes can have joint issues, but having diabetes raises your risk. All of these conditions seem to be related to thickening or stiffening of connective tissues — the ligaments and tendons that hold our bodies together. These tissues are mostly made of collagen, a protein that should have some give and flow to it, like a soft rubber ball. When collagen stiffens, joints start to hurt and don’t work as well. Here are four of the more well known diabetes-related joint conditions: Frozen shoulder, also known as adhesive capsulitis, is a condition in which the range of motion of the shoulder joint is severely restricted. According to the American Diabetes Association, it affects 20% of people with diabetes and 5% of the general population. It usually starts with shoulder pain and inflammation and can progress to stiffness and near-complete immobility. Then it starts to resolve, and is usually gone within two years, especially with treatment. Diabetic stiff hand syndrome is a painless disorder caused by an increase in collagen in and just below the skin. It can sharply limit hand function. Carpal tunnel syndrome (CTS) is a painful condition caused by pressure on the median nerve, which passes into the hand through a narrow “tunnel.” If this tunnel is squeezed by thickening of ligaments or other structures, severe pain can result. CTS is often associated with typing or other repetitive work that keep wrists in unnatural positions. Trigger finger is a condition where one or more fingers curl up and are difficult to straighten. The tendons Continue reading >>

Diabetic Charcot Neuroarthropathy Of The Hand: Clinical Course, Diagnosis, And Treatment Options

Diabetic Charcot Neuroarthropathy Of The Hand: Clinical Course, Diagnosis, And Treatment Options

During the treatment of diabetic Charcot neuroarthropathy (CN) of the foot in two young patients, we discovered atypical alterations of their hands with loss of strength and paresthesia combined with atypical and nonhealing bone alterations and instability. Whereas CN of the foot is a serious and well-known complication of diabetes, CN of the hand is only mentioned in four articles (1–4). We reviewed all patients who had been treated in our clinic for CN of the foot (N = 281) from 1998 to 2010. We scanned all patient reports for X-rays or complaints of the hand and visible alterations. Photo documentation and X-rays of the affected joints were obtained after the patients had given formal consent and all demands of the Declaration of Helsinki were fulfilled. Three patients with CN of the hand were included; all of them were female (25, 31, and 62 years old at admission). Two patients had type 1 diabetes, and one had type 2 diabetes. All three were found to have swelling, loss of strength, and severe paresthesia of the hand. All these patients had been suffering from diabetes for more than 10 years, and all showed multiple complications of the diabetes, one of which was severe polyneuropathy of the affected joints. One patient died before the age of 36 years. All patients complained of loss of strength with trouble to perform activities of daily living, which was verified by neurologists. There was painless paresthesia and swelling of the affected joints. The diagnosis of polyneuropathy and CN of the hand was made in our clinic for the first time at first admission, even though the patients had seen various physicians before. The X-rays showed disintegration of the joints and destruction of the bone comparable to that seen in Eichenholtz stages of CN of the foot (Fig. 1 Continue reading >>

Oh My Aching Hands: It May Not Be Neuropathy

Oh My Aching Hands: It May Not Be Neuropathy

Arthur Segal had Type 2 diabetes for many years. So when he began to have trouble opening medication bottles and turning door knobs, using a knife and counting his change, he assumed it was neuropathy and that nothing could be done. Most people with diabetes have heard of a condition called diabetic neuropathy. Diabetic neuropathy takes many forms and its effects vary from person to person. Because of this, treatment is often difficult and outcomes vary depending on the nature of the individual case. However, your pain may not be due to diabetic neuropathy at all. Long-term diabetics with hand pain may actually be suffering from other hand conditions. These two often-overlooked conditions are carpal tunnel syndrome and trigger finger. According to Dr. Keith Segalman, orthopedic hand surgeon with the Curtis Hand Center at Union Memorial Hospital in Baltimore, MD, both of these conditions are more prevalent in diabetics than in the general public. Surprisingly, these conditions are not caused by poor circulation, nor are they forms of diabetic neuropathy. In long-term diabetics, advanced glycation end-products, or AGEs, can collect on the tendons in the palms of the hand. The accumulation causes the tendons to thicken, thereby causing nerve compression by pressing on the nerve in the carpal tunnel. This leads to numbness and tingling, similar to neuropathy symptoms, especially when the hands are in certain positions. Many diabetics also find that they have stiffness or restricted movement in one or more fingers. This may be due to trigger finger. Trigger finger results when the thickened tendons can no longer slide easily through the cartilage rings along the fingers. The rubbing causes the tendon to swell even further to the point where the tendon can no longer slide thr Continue reading >>

Diabetic Neuropathy

Diabetic Neuropathy

Print Overview Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerve fibers throughout your body, but diabetic neuropathy most often damages nerves in your legs and feet. Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart. For some people, these symptoms are mild; for others, diabetic neuropathy can be painful, disabling and even fatal. Diabetic neuropathy is a common serious complication of diabetes. Yet you can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle. Symptoms There are four main types of diabetic neuropathy. You may have just one type or symptoms of several types. Most develop gradually, and you may not notice problems until considerable damage has occurred. The signs and symptoms of diabetic neuropathy vary, depending on the type of neuropathy and which nerves are affected. Peripheral neuropathy Peripheral neuropathy is the most common form of diabetic neuropathy. Your feet and legs are often affected first, followed by your hands and arms. Signs and symptoms of peripheral neuropathy are often worse at night, and may include: Numbness or reduced ability to feel pain or temperature changes A tingling or burning sensation Sharp pains or cramps Increased sensitivity to touch — for some people, even the weight of a bed sheet can be agonizing Muscle weakness Loss of reflexes, especially in the ankle Loss of balance and coordination Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain Autonomic neuropathy The autonomic nervous system controls your hea Continue reading >>

Diabetes And Hand Pain

Diabetes And Hand Pain

Richard A. Bernstein, MD The effect of diabetes goes beyond problems with blood sugar: diabetes may also be affecting your hands. There are four hand problems that occur in patients with diabetes, many of which can be easily addressed and treated. Carpal tunnel syndrome is not only a problem in assembly workers or people who spend their days on computers. Diabetes also puts you at risk for developing this problem. Carpal tunnel syndrome involves pressure on one of the three major nerves coming down to the arm, specifically to the thumb, index, and long fingers. Numbness and tingling are common symptoms as well as pain that oftentimes awakens people from sleep. Many people develop symptoms while driving a car or reading a book or newspaper. Some- times it is simply numbness, other times pain can develop with an aching sensation. People will commonly try to shake their hands to restore sensation. Splints and therapy can help diminish the symptoms of carpal tunnel compression and despite what people hear, surgery is often not needed for this condition. There have been some reports of good success with the so-called cold laser. Th is ultrasound-like wand has been used in Europe and one study was done at a large car assembly plant showing that it can help diminish the pain and discomfort of carpal tunnel. Second, pain, clicking and the sense of locking of one’s finger is medically known as a trigger finger. This condition is also more common in patients with diabetes and sometimes will cause a painful locking of the finger, especially when getting up in the morning. Rather than locking, some people develop a less severe example of trigger finger pain. Tendonitis, is an inflammation of the tendons. It usually affects the tendons which allow us to bend our fingers. Similar t Continue reading >>

Tips For Treating Diabetic Nerve Pain

Tips For Treating Diabetic Nerve Pain

Diabetes can cause long-term problems throughout your body, especially if you don’t control your blood sugar effectively, and sugar levels remain high for many years. High blood sugar can cause diabetic neuropathy, which damages the nerves that send signals from your hands and feet. Diabetic neuropathy can cause numbness or tingling in your fingers, toes, hands, and feet. Another symptom is a burning, sharp, or aching pain (diabetic nerve pain). The pain may be mild at first, but it can get worse over time and spread up your legs or arms. Walking can be painful, and even the softest touch can feel unbearable. Up to 50 percent of people with diabetes may experience nerve pain. Nerve damage can affect your ability to sleep, decrease your quality of life, and can also cause depression. Damaged nerves can’t be replaced. However, there are ways that you can prevent further damage and relieve your pain. First, control your blood sugar so the damage doesn’t progress. Talk to your doctor about setting your blood sugar goal, and learn to monitor it. You may be asked to lower your blood sugar before meals to 70 to 130 milligrams per deciliter (mg/dL) and your blood sugar after meals to less than 180 mg/dL. Use diets, exercise, and medications to decrease your blood sugar to a healthier range. Monitor other health risks that can worsen your diabetes, such as your weight and smoking. Ask your doctor about effective ways to lose weight or quit smoking, if necessary. Your doctor might suggest trying an over-the-counter pain reliever, such as acetaminophen (Tylenol), aspirin (Bufferin), or ibuprofen (Motrin IB, Advil), which are available without a prescription but can cause side effects. Use a low dose for a short time to control your symptoms. Other options exist for stronger Continue reading >>

Diabetes And Your Hands

Diabetes And Your Hands

While it’s common knowledge that diabetes involves an elevation of a person’s blood sugar, it is not well known why diabetes can cause stiffness of the hands, shoulders, and other joints and how exactly it plays a role in diseases like trigger finger and Dupuytren’s contracture. Diabetes Stiff Hand Syndrome Diabetes can cause stiffness of the hands in a condition known both as diabetic stiff hand syndrome or diabetic cheiroarthropathy. It is an uncommon condition in which a person’s finger movement becomes decreased and the hands take on a thickened and waxy appearance. As it turns out, people with both type 1 diabetes and type 2 diabetes can both get the disorder. People who keep their blood sugars under good control and partake in physical therapy usually can overcome the condition. Diabetes stiff hand syndrome is found in 8 to 50 percent of type 1 diabetic patients. Lesser numbers of type 2 diabetic patients will come down with the disease. The longer a person has diabetes and the worse control of the diabetes the person has, the greater is the chance of getting diabetic cheiroarthropathy. People who have diabetes that results in diabetic neuropathy have a greater chance of having stiff hands when compared to diabetics who don’t have diabetic neuropathy. Common symptoms of diabetic stiff hand syndrome include an inability to move the joints very much, which winds up causing limitations in the function of the hand. Usually the stiffness starts in the smallest fingers of the hands and progresses so that eventually all of the fingers are affected. In the most severe cases, the individual with stiff hand syndrome are unable to clench the hands at all and the fingers stick straight out, unable to hold onto anything with any degree of strength. The skin is also a Continue reading >>

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