The Canary In My Coal Mine

| Feb 1, 1996

The big news of the day for me is that carpal tunnel syndrome (CTS) is one of a group of muscular-skeletal manifestations common to diabetes. Most people know about retinopathy [eyes], nephropathy [kidneys], and neuropathy [nerves]. But many are not aware of this whole other group of degenerative problems that relate to the joints.

In March 1995, Todd Kaye, MD published an excellent article about this group of muscular-skeletal problems in Practical Diabetology. He explained that CTS is grouped in with trigger finger, frozen shoulder, charcot foot, and osteoporosis. Also in the group is a condition called diabetic hand syndrome which affects 30% to 40% of people with diabetes. If you can't hold your hands in a "prayer position" you may be one of those with this problem.

Diabetic hand syndrome has been consistently associated with retinopathy, and may precede it by up to five years. When I think of these disorders, I am reminded of the method coal miners once used to detect deadly gas within the mines-they'd bring a canary down with them, and if the bird died, the miners knew there was trouble and evacuated. Dr. Kaye's article didn't mention blood sugar control, but we learned from the DCCT that high blood sugar increases the rate of complications from diabetes. CTS, for me, is a canary in my coalmine. Are my BGs too high? This thought was already on my mind when I got a phone call that rocked my socks.

Richard K. Bernstein, MD, is on the DIABETES HEALTH medical advisory board and has had diabetes himself for 50 years. He has authored two books on diabetes and is known for his belief that a high-protein, low-carbohydrate diet is the key to good glucose control-he has maintained this philosophy through the ever-changing "fashions" in diabetes management. When I interviewed Richard on my radio show four years ago he told me he hadn't eaten a slice of bread in 20 years. At the time, I thought he was a nut. Now I would call him a visionary.

He asked me about my A1c-it's generally about 7.4%, which corresponds with an average BG of 180 mg/dl. Richard says my A1c should be 5.2%, which indicates an average BG of 90 mg/dl.

Richard says that good glucose control could alleviate carpal tunnel syndrome. When BG levels are too high, the proteins in the tendon around the carpal tunnel nerve are glycosylated, causing the tendon to become inflamed and stiff. He also said that losing weight can help, and that reducing salt intake is important since sodium causes fluid retention, which in turn causes the tendons to swell further.

I talked to some friends who agree with Richard. Evelyn Narad has normalized her BGs and lost 75 pounds thanks to his "method"-see DIABETES HEALTH, July 1995, page 18. Well-known diabetes writers Barbara Toohey and June Biermann are also doing well on Richard's recommended diet-Barbara lost six pounds in six weeks, and June's blood glucose levels have stabilized around the 100 mg/dl mark since they started limiting carbs. Richard recommends that people with diabetes eat no more than six grams of carbs for breakfast, and no more than twelve for lunch and dinner.

DIABETES HEALTH reader Bob called to say that people with diabetes get CTS more frequently because of fluctuating blood glucose levels. "Every time our blood sugar shifts it causes osmotic pressure changes in the tendon sheath."

Michael Brownlee, MD, of the Albert Einstein College of Medicine in New York City says that in people with diabetes, proteins can attach to glucose molecules, forming what he calls "biological superglue." The sticky molecules become a constant irritation to the body, which can lead to problems like CTS. (see the article "Antioxidants" in the January 1996 issue of DIABETES HEALTH, page one.)

I take vitamins faithfully, including inositol. Inositol is a member of the vitamin B family. Reader Gordon says that he took inositol once a day for five months-after two weeks the CTS "started to go away." Paul Schickling, a pharmacist who writes for DIABETES HEALTH, recommends 500 mg of inositol twice per day. As I mentioned in the last issue, I take it along with vitamins C, B complex, B6, and zinc.

I would like to follow Richard's diet regimen, although I realize it will entail a major lifestyle change. Since I cook for my kids, my new diet will mean preparing different meals. I want that 5.2% A1c, but I wonder if I can achieve it without major changes in my diet. A low-carb mealplan was one of my New Year's resolutions-in my the next issue I'll let you know if I can stick to it.

I am coming to terms with my problem as I gain more knowledge about what I can do for myself. I feel that my CTS has gotten somewhat better-the pain is gone and I no longer need to wear the wrist splints every night. In a way, CTS is a blessing. Like the canary in the coalmine, CTS's appearance showed me that it's time to take better care of myself.

Click Here To View Or Post Comments

Related Article

Carpal Tunnel Syndrome a Common Cohort of Diabetes

Jun 29, 2007


Categories: A1c Test, Blood Glucose, Blood Sugar, Diabetes, My Own Injection


Take the Diabetes Health Pump Survey
See What's Inside
Read this FREE issue now
For healthcare professionals only

You can view the current or previous issues of Diabetes Health online, in their entirety, anytime you want.
Click Here To View

See if you qualify for our free healthcare professional magazines. Click here to start your application for Pre-Diabetes Health, Diabetes Health Pharmacist and Diabetes Health Professional.

Learn More About the Professional Subscription

Free Diabetes Health e-Newsletter

Latest
Popular
Top Rated
Print | Email | Share | Comments (0)

You May Also Be Interested In...


Comments


Add your comments about this article below. You can add comments as a registered user or anonymously. If you choose to post anonymously your comments will be sent to our moderator for approval before they appear on this page. If you choose to post as a registered user your comments will appear instantly.

When voicing your views via the comment feature, please respect the Diabetes Health community by refraining from comments that could be considered offensive to other people. Diabetes Health reserves the right to remove comments when necessary to maintain the cordial voice of the diabetes community.

For your privacy and protection, we ask that you do not include personal details such as address or telephone number in any comments posted.

Don't have your Diabetes Health Username? Register now and add your comments to all our content.

Have Your Say...


Username: Password:
Comment:
©1991-2014 Diabetes Health | Home | Privacy | Press | Advertising | Help | Contact Us | Donate | Sitemap

Diabetes Health Medical Disclaimer

The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained on or available through this website is for general information purposes only. Opinions expressed here are the opinions of writers, contributors, and commentators, and are not necessarily those of Diabetes Health. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website.