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April 4, 2003

Complications

Question from Virginia, USA:

I have had type 1 diabetes for about a year, and I'm having trouble with numbness and tingling in my fingers. Besides having diabetes, I play guitar for livelihood which is enough to cause compressional nerve damage and cut off circulation in itself. The numbness comes and goes, but for now, it's consistently fine when my blood glucose is normal. When my blood glucose is high, I get numb. The skin color seems good. With the exception of the past month, my glucose has been outrageously out of control (250-550 mg/dl [13.9-30.6 mmol/L] usually) for most of the last six months, during which time I've had to put in some long hours in the studio. The past month, I've adjusted my insulin, and I've been under 200 mg/dl [11.1 mmol/L] most of the time and usually close to normal. Are people with diabetes more susceptible to compressional nerve damage? How does one differentiate among mild circulation trouble, compressional neuropathy, and diabetic neuropathy?

Answer:

Indeed, people with diabetes do have an increased risk of compression neuropathies. Epidemiological data regarding carpal tunnel syndrome suggest this is much higher in people with diabetes. You then put the repetitive injury into it, and you do have an increased risk.

The way you evaluate this is with a trained neurologist who has experience with peripheral nerve injury. You can also tell a lot by having an EMG which can help localize where the compression injury may be. Given your occupation, I would suggest you seek out this evaluation.

JTL