[MD-AtLarge] NFB Diabetes Support Call

[nfbmd]

Hello all,
 
If you or someone you love has diabetes and is blind or experiencing  vision
loss,  join us for NFB of Maryland's free one hour Diabetes support call for
education and encouragement.  The call is on Thursday, August 4 at 7 pm.
 
To get on call dial:
(641) 715-3272
then use access code: 720125#
 
This month,  we will be discussing lesser-known diabetic complications
including pain in hands. See Voice of the Diabetic article below. 
 
 
Oh My Aching Hands: It May Not Be Neuropathy

by Thomas Rivera Ley


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 through the
ring.  


You may notice that one or more of your fingers will not close all the way
when you attempt to make a fist or hold an object.  If you are able to force
your finger to close, the tendon is forced through the ring but then cannot
slide back. Your finger gets stuck in the closed position; thus the term
trigger finger. This can be quite painful and cause a dramatic decrease in
the usability of the hand and fingers. 

The good news is that both of these conditions can usually be treated very
successfully. For carpal tunnel syndrome, laparoscopic surgery can be used
to open the tunnel relieving the pressure on the nerve. Trigger finger can
be treated with local injections of cortisone into the joint, and if this is
not successful, minor surgery can be performed to loosen the ring of
cartilage to allow the tendon to pass freely once again.

The important lesson is that not all problems with the diabetic hand are
caused by diabetic neuropathy, and in the case of carpal tunnel and trigger
finger, treatments are usually quite successful. Your hands are an
invaluable tool for managing your diabetes, especially if you have visual
complications.  So seek the advice of a hand specialist as soon as symptoms
appear. 


 
 
Sharon Maneki, President
National Federation of the Blind of Maryland
410-715-9596
 
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