I am 34 years old and have had diabetes for 27 years. My questions are related to "Diabetic Stiff Hand Syndrome" which I was diagnosed with a year ago. Using my computer at home is a painful endeavor. I have DragonDictate at work and am an expert, but I can no longer perform my duties even at half time and will be either forced to resign or be fired on 9/16. Anyway... I have not been able to find any literature or other information on this condition. My physiatrist could only come up with an article that made only a short reference to it with very little explanation. My internist had never heard of it before. I was told that the tendons in my hands and arms are shortening and the condition will deteriorate progressively and is painful. He sure got the "painful" part right! What can you tell me about this condition? Can you recommend any reading material? I would like to talk to other people who have this. Any information you can share will be very much appreciated.
The diabetic stiff hand syndrome in your case is probably a beginning of the stiff man syndrome. The relationship to Type 1 diabetes is that in both conditions you get anti-GAD antibodies. This condition and also those of Duputryn's contracture, carpal tunnel syndrome and flexor tenosynovitis are associated with diabetes and thought to be due either to vasculitis or to some form of autoimmune syndrome. Plasmapheresis has been described as a very successful remedy for what you describe.
Your nearest medical library should be able to get photostats which you could then share with your physician. Here are a few from an extensive literature:
- Journal of Hand Surgery 20:109, 1995
- Journal of Neurology 242:618, 1995
- Journal of Immunology 156:818, 1996
Original posting 3 Oct 96
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