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September 18, 2000

Complications

Question from Massachusetts, USA:

My 77 year old mother has type 1 diabetes for over 20 years and had left hand, shoulder, and face tremors (with a sugar level of 500 mg/dl [27.8 mmol/L]) when she went to the ER. They relate the tremor-seizure to the high sugars (nothing found in EEG or CT scans). They cannot control the sugar levels, and she goes from lows of 70 mg/dl [3.9 mmol/L] to highs of 400s mg/dl [22.2 mmol/L], with off-the-wall mood swings. Is this a stiff hand syndrome? Why can't the levels be controlled?

Answer:

Several things come to mind reviewing your description. Your mother was older with onset of her diabetes. Does she really have a form of type 2 diabetes? I have seen cases where patients with type 2 diabetes have tremors from the high blood sugars.

The number of causes for tremor is very large, and I would not accept the tremors as being from her diabetes until after a thorough medical evaluation. With regard to the large swings in blood sugars, it is a well known problem that this can occur with both type 1 and type 2 diabetes. You need to get help in treating these, as people do feel badly with the swings, and changes in mood can be a symptom of this problem.

JTL