I am a 33 year old male, and have developed a “trigger finger” in my ring and long fingers in both hands over the last six months. During that time I have also developed alopecia of my beard (probably 15-20% of my beard is gone in round patches), and I developed plantar fasciitis in both heels, first the left, later the right. I have six siblings; one brother and one sister have hypothyroidism as does my mother. I have a nephew with celiac disease as well. I do not have diabetes, but I am concerned that I might have some autoimmune poly-disorder that could include diabetes, since, at my initial consultation with him, my hand doctor was surprised to hear that I did not have type 1 diabetes, given my hand condition at my age. Should I be concerned? Is there any blood work I should have done to confirm antibodies, etc? Or should I just relax and not worry about it?

Certainly you have a family and personal history that is very suggestive indeed of what is sometimes called the “Autoimmune Polyglandular Syndrome Type II.” It isn’t of course really polyendocrine or polyglandular, as a wide variety of tissues may be involved. Autoimmune diabetes is a common but not inevitable component of the syndrome.

In your case, I think you might suggest to your doctor that he does do a fasting blood sugar and a test for glucosuria. It would also might help confirm the diagnosis of the syndrome if you had a positive anti-GAD (glutamic acid decarboxylase) test. This is often positive in the fasciitis cases and does not indicate that you might develop diabetes. However if an anti-insulin antibody test and an anti-ICA512 (Islet Cell Antibody) test were also done at the same time and were positive it would be a stronger indication that you might develop a late form of Type�1A diabetes. No treatment for diabetes would be indicated before you had definite signs of glucose intolerance (which you may never develop). In any case relax!

DOB