Diabetes Information Library 
Your Source For Articles On Diabetes  
Search Articles:
Bookmark Our Site! Free Newsletter | Special Offers | Archives | Diabetic Dictionary  
 Home
a1c
aIc
acetyl l-carnitine
alpha lipoic acid
american diabetes assoc.
benfotiamine
bilberry
bitter melon
blood sugar
blood sugar level
carnosine
cause of diabetes
chromium
cinnamon
diabetes
diabetes care
diabetes diet
diabetes education
diabetes food
diabetes information
diabetes insipidus
diabetes management
diabetes medication
diabetes mellitus
diabetes menu
diabetes news
diabetes nutrition
diabetes recipe
diabetes research
diabetes statistics
diabetes symptom
diabetes test
diabetes treatment
diabetes type ii
diabetic
diabetic cake recipe
diabetic complications
diabetic cookie
diabetic cooking
diabetic dessert recipe
diabetic diet
diabetic exchange
diabetic food list
diabetic meal planning
diabetic menu
diabetic neuropathy
diabetic nutrition
diabetic product
diabetic recipe
diabetic retinopathy
diabetic symptom
diabeties
diabetis
exchange diet
exercise
fenugreek
food exchange
gestational diabetes
gestational diabetes diet
glucose
glycemic index
gulvel
gymnema sylvestre
healthy carbs
hemoglobin a1c
herb for diabetes
high blood sugar
high triglyceride
hyperglycemia
idiopathic neuropathy
insulin
insulin resistance
jambolan
juvenile diabetes
low blood sugar
low carbohydrate diet
metabolic syndrome
methylcobalamin
nerve damage
neuropathy
neuropathy symptoms
normal blood sugar level
peripheral neuropathy
preventing neuropathy
pterocarpus marsupium
pyridoxal-5-phosphate
recipes
retinopathy
sign of diabetes
sugar diabetes
symptom juvenile diabetes
syndrome x
triglyceride
type 1 diabetes
type 2 diabetes
type 2 diabetes diet
types of neuropathy
vanadyl
vanadyl sulfate
zinc
Printer Friendly Version

Get A "Grrip!": Diabetes and Your Hands

(Overview of Diabetes-Related Hand Disorders)

Author: Lori B. Siegel and Stephen R. Huang
Source: Diabetes Forecast, 4/1/2003

When you hear about the complications of diabetes, you usually hear about your heart, eyes, kidneys, nerves, and feet. But diabetes can affect the muscles and joints of your hands, too. Diabetes-related hand conditions are usually not life-threatening, but they can have a great impact on the quality of your life.

Poor blood sugar control is thought to play a major role in diabetes-related musculoskeletal disorders of the hands. The theory is that high blood sugars change the amount and character of the protein and collagen in your tissues, leading to damage of small blood vessels.

Three musculoskeletal conditions associated with diabetes can affect your hands: stiff-hand syndrome, Dupuytren's contracture, and carpal tunnel syndrome.

Stiff-Hand Syndrome

Stiff-hand syndrome is a painless disorder caused by an increase in collagen in and just below the skin. The stiffness begins in the little finger and spreads to the thumb. Eventually, the stiffness can make it difficult for you to fully extend your fingers. Thick, tight, and waxy skin may also develop on the back of your hand.

To see if you might have stiff-hand syndrome, hold your palms together like you are praying. Can you make all of the skin and joints of your palms and fingers touch? If not, you may have stiff hand syndrome.

Hand stretches and muscle strengthening exercises may correct stiff-hand syndrome. First, warm up your hands with warm water (use your elbow to check the water's temperature), then remove them from the water, dry them, and gently stretch your hands. With your right hand, manually move the fingers of your left hand through their full range of motion, up and down, bending each joint. Then use your left hand to manipulate the fingers of your right hand. Practice making and releasing a fist with each hand. Try to touch your right thumb to each finger on your right hand. Then repeat the exercise with your left hand. Never force a stretch, however, and if it hurts, stop.

If these exercises hurt, or if they do not help alleviate your symptoms, physical therapy may help. Paraffin wax treatments, carefully administered by a therapist in a medical setting, may also help.

The best treatment for stiff-hand syndrome is prevention. In addition to keeping your blood sugars in control, practice playing with a ball or clay to keep your hands strong and flexible.

Dupuytren's Contracture

Like stiff-hand syndrome, Dupuytren's contracture can be attributed to increased collagen in the tissues that connect and separate the skin, muscles, and tendons of the hand. As a result, the tendons of the fingers become shortened and unable to glide over one another properly. The fingers are pulled into the hand, making it hard or impossible for you to open your hand fully.

One early symptom of this condition, called "trigger finger," is characterized by a "locking-up" sensation in one or more fingers. (The index and middle fingers are most often involved.)

As with stiff-hand syndrome, the best treatment is prevention, based on good blood sugar control and regular range-of-motion and strengthening exercises for the hands. Heat also seems to help, but remember to check the temperature of warm water with your elbows.first. Over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen and naproxen may help. If you have kidney disease, however, you should talk to your doctor before taking NSAIDs. (People who have kidney disease should only use NSAIDs under a doctor's supervision.)

If your fingers begin to lock or get stuck, a local corticosteroid injection by a hand surgeon, orthopedic surgeon, or rheumatologist may allow for more mobility. These injections should be used with caution because they may temporarily raise your blood sugars. If you get such a shot, monitor your blood sugars very carefully for 24 hours afterward.

Splints to hold the fingers in an extended position may be helpful if your fingers seem to be locking up very quickly. Surgery is also possible, but it's a last resort.

Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS), which is most commonly associated with repetitive stress and use of the hands, occurs more frequently in people with diabetes than in the general public. Among people with diabetes, CTS is more common in those who have neuropathy.

The carpal tunnel is a small area of the wrist through which many structures pass, including a major nerve called the median nerve. A band of ligaments surrounds the carpal tunnel. Any prolonged stress on this area or thickening of the band will increase the pressure in the carpal tunnel and possibly compress the median nerve. If you have diabetes, high blood sugars may alter collagen in your wrist and increase pressure on the carpal tunnel.

Symptoms of CTS include numbness and tingling in the thumb and index, middle, and ring fingers of the hand. It may occasionally involve the pinkie as well. Your hands may feel like they are asleep. The changes in collagen and nerves often occur at night, so the symptoms may wake you up. You may also have symptoms during the day when you flex your wrists. The discomfort, although most common. in the hand, may extend back to the elbow.

Your doctor can diagnose CTS by tapping the affected ligament or holding your hands together in an, inverted prayer position, the backs of the hands together, fingers pointed down. If other nerve problems are a concern, your doctor may also test your nerve conduction by placing electrodes on your skin in various places, then stimulating the nerves with mild electrical impulses. Your doctor should test for muscle strength in your hands because prolonged, untreated CTS may result in irreversible weakness.

There are several ways to treat CTS. The first step involves reducing any activity that may place additional stress on the median nerve. You may have to wear a splint to hold your hands and wrists in a neutral position. It is important to wear the splints as much as possible during the day. You should also wear them at night because you may change your position in your sleep and aggravate the condition.

Along with splinting, an occasional corticosteroid injection into the carpal tunnel may help reduce any inflammation. This should be done by the appropriate specialist and you should monitor your blood sugars carefully for 24 hours afterward.

If these treatments are ineffective, the pain is disabling, or there are signs of muscle weakness or atrophy, it might be tirne to consider surgery.

When it comes to your hands, good blood sugar control and exercise can go a long way. Keeping your hands limber will not only lessen your risk of future hand problems; it will also greatly contribute to your independence and enjoyment of life.

Lori B. Siegel, MD, FACP, is a professor of medicine and chief of the Division of Rheumatology in the Department of Medicine at Finch University of Health Sciences at the Chicago Medical School in North Chicago, Ill. Steven R. Huang, MD, is a family-practice resident at Maine Medical Center in Portland, Maine.

Flourish

  Recommended
Product
Maintain Healthy
Blood Sugar Levels*

Glucobetic


Price $33.95

Testimony
I Feel So Much Better!
"I have been taking Glucobetic and have seen a remarkable difference. I actually am having a normal blood sugar reading everyday without fail. I just wish I had started this product a long time ago. I really do feel so much better - the sluggishness is gone and I feel like my old self again. Thanks !!"** 
  - A. Workman, OK

Product Details


Recommended
Product!


Sleep So Well
60 Capsules

Calm, Restful Sleep*


Price $17.95




 

Recommended
Product!



Probiotic Digestive Support

Targets Gas, Bloating & DIfficult Digestion*


Price $27.95






Vitalicious Natural Muffins-100 Delicious Calories


Copyright Act Notice                       

*Many of the statements on this web site have not been evaluated by the Food and Drug Administration or other government, research or academic body; any that were are so marked. This information is not intended to diagnose, treat, cure or prevent diabetes or any disease. Information on this site is provided for informational purposes and is not meant to substitute for the advice provided by your own physician or other medical professional. Not intended to diagnose or prescribe for medical or psychological conditions nor to claim to prevent, treat, mitigate or cure such conditions. You should not use the information contained herein for diagnosing or treating a health problem or disease, or prescribing any medication. Any products advertised are from third parties. You should read carefully all product packaging. You should consult with a healthcare professional before starting any diet, exercise or supplementation program. Do not discontinue the use of prescription medication without the approval of your physician.

**Results not typical; your results may vary.


***Recipes provided usually include nutritional information and diabetic exchanges. Not all recipes are appropriate for all people. Please make sure a recipe is appropriate for your meal plan and pay careful attention to serving sizes. User is solely responsible for their use of any content provided.