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January 10, 2001


Question from Woodlands, Texas, USA:

I am a 26 year old female who has had type 1 diabetes for 21 years. I have always maintained good control (A1c averages 6.5-7.0%), and I have been on an insulin pump for four years. Recently, I have started getting sharp, stinging pains in my hands that have gone up to my elbow at times when I wake up. I asked my endocrinologist about neuropathy and she said that should not be a concern. Does this sound more like carpal tunnel syndrome, as opposed to the early signs of neuropathy?


The symptoms of carpal tunnel syndrome tend to be localized to the hand. The use of the hands makes the symptoms worse. Early, there is discomfort. Later, there can be weakness and the dropping of objects. Distal neuropathy due to diabetes is characterized by numbness and tingling in the hands and also the feet. The referral of pain to the elbow doesn’t sound right for either. You can have compression syndromes in which there is entrapment of the nerve at the elbow. Sometimes, your doctor needs to order a test called an electromyelogram (EMG) in order to pinpoint the source of the pain and dysfunction.