Type 1 Diabetes and Hand Disorders

Understanding Dupuytren’s Contracture, Trigger Finger, and Carpal Tunnel Syndrome

Adults with Type 1 diabetes (T1D) are more likely to experience certain hand disorders, including Dupuytren’s contracture, trigger finger, and carpal tunnel syndrome. These conditions, known collectively as “diabetic hand syndrome,” are more common in people with long-standing diabetes and can impact daily function and quality of life.

Are These Hand Conditions More Common in Type 1 Diabetes?

Yes. People with Type 1 diabetes are at increased risk for:

• Dupuytren’s contracture: Thickening and tightening of the tissue under the skin of the palm, causing fingers—especially the ring and little finger—to curl inward.
• Trigger finger (stenosing tenosynovitis): Inflammation around a tendon that causes the finger to lock or catch when bent.
• Carpal tunnel syndrome (CTS): Compression of the median nerve in the wrist, leading to pain, tingling, or numbness in the hand and fingers.

These conditions are 2 to 3 times more common in people with diabetes than in the general population.

Why Is This More Common in Diabetes?

The exact cause isn’t fully understood, but contributing factors include:

• Chronically high blood glucose may lead to glycation of collagen, making tissues stiffer.
• Microvascular changes can affect blood flow to the nerves and connective tissue.
• Inflammation and metabolic changes over time can impact tendon health.

Longer duration of diabetes, poor glycemic control, and older age increase the risk.

Screening and Diagnosis

There are no official screening guidelines, but people with T1D should tell their healthcare provider if they experience:

• Numbness, tingling, or burning in the hands.
• Fingers that feel stiff, lock up, or are difficult to straighten.
• Pain or tightness in the palms or wrists.

Annual diabetes checkups should include questions about mobility and nerve function, particularly after 10+ years with the disease.

Treatment Options

• Early intervention: Rest, splinting, physical therapy, or corticosteroid injections.
• Advanced cases: May require surgical release or minimally invasive procedures (e.g., needle aponeurotomy for Dupuytren’s, or carpal tunnel release).
• Blood sugar management: Good glycemic control can slow progression and improve healing.

Who Should Treat These Conditions?

• Hand specialists (orthopedic surgeons with a focus on hand surgery) are often involved in diagnosis and treatment.
• Neurologists may assist with carpal tunnel syndrome evaluations.
• Endocrinologists and primary care providers play a role in monitoring and coordinating care.

Bottom Line: If you have Type 1 diabetes and experience hand pain, stiffness, or numbness, don’t ignore it. These hand disorders are more common in diabetes—but with early diagnosis and proper care, they can often be managed effectively. Talk to your doctor about any symptoms and keep them informed at your regular diabetes checkups.

Current References

1. Vetrano IG, et al. Musculoskeletal disorders in diabetes mellitus: An update. Acta Diabetol. 2023;60(1):1-14.
   https://doi.org/10.1007/s00592-022-02048-9
2. Rydberg M, et al. Diabetic hand: prevalence and incidence of diabetic hand problems using data from 1.1 million inhabitants in southern Sweden. BMJ Open Diabetes Res Care. 2022 Jan;10(1):e002614.