Living With Diabetes & Fingertip Sensitivity
Most people with diabetes check their blood sugar using a lancing device on their fingertips. Over time, this process often results in fingers that have: Increased soreness and swelling, visible puncture marks, continuous low-level area pain, callouses, loss of tactile sensation. While these symptoms can be annoying, for those whose professions depend on them being able to sensitively feel with their fingertips, it can also lead to a significant decrease in job performance. Repeated and prolonged “fingersticks” can cause a reduction in concentration due to pain triggered when pressure is exerted on the pads of their fingers.
Repeated lancing to test blood sugar leads to loss of tactile sensation, as well as bruise marks and callouses.
There are many examples of tactile dependent professions: IT, Graphic Design, Customer Service, Marketing, Musicians, particularly those playing stringed instruments, Healthcare, Electricians, Medical professionals, particularly surgeons There are many approved disability claims stemming from a person not having the required tactile sensitivity to do their job even though they were otherwise able bodied. Sadly, a person with diabetes could have extreme loss of tactile sensation, but not the loss of pain. That is, after testing their blood by lancing their fingers, over time, they reach the point where even though they couldn’t feel a difference in various textures it still hurts when they lance.
What makes the loss of finger tactile sensation even more difficult to deal with, unlike the loss of senses such as hearing or taste, is that when the loss occurs gradually, such as caused by finger lancing, the deterioration is usually not obvious to the person being afflicted. In fact, there is a test, nicknamed the “Sand Test”, where a panel of different textures is moved past the fingertips of the subject being tested. With their eyes closed, using only tactile sensation, the subject has to identify when the texture of the panels surface changes. Similar to how eyes are tested on an eye chart, the lower you go on the panel, the more difficult the texture is to differentiate. This test shows that people who repeatedly lance their fingers, such as those with diabetes do, can lose up to 60% of their tactile acuity. This compromises the joy of living, and for people whose profession depends on being able to accurately know the positions and/or texture of what they are touching, it is even worse because this can hurt them professionally.
Tactile nerves gradually withdraw from areas of pain so tactile sensation is also lost even when the finger poking is not directly on the area being tested. For instance, poking the side of the finger can cause a loss of sensation on the pad of the finger, and vice versa. The loss of sensation can even extend to adjoining fingers, rather than just the one that was being pricked. This loss of sensation in fingertips, as well as pain and callouses resulting from repeated lancing, is another reason why alternate site testing is gaining such strong interest within the modern medical community. Now alternate site testing is both accessible and practical. In fact, the FDA has cleared one standalone pain-free lancing device for use on alternate sites, as well as fingers.
Modern research has shown that under regular conditions, blood glucose levels are the same anywhere on the body, except in cases when it is rapidly changing, such as after eating, intense exercise, or taking fast acting medication. In those cases, fingertip testing reacts 15 minutes faster than many alternate sites. However, there is still no reason to test on fingers, as testing on the palm gives the same fast-acting reading.
Now recovery is possible. In time, once a person has switched to alternate site testing, it will give fingers a break. Not only will the finger pain, soreness, and bruise marks go away in about 5 weeks, but within 2-3 months, there will be an 80% return of tactical sensation. This modern application of alternate site testing is now available, and is a significant benefit to those with diabetes. Even those who use Continuous Glucose Monitors need to do do manual glucose checks sometimes. For example, when they may be getting sensor errors, have an expired sensor, are warming up or calibrating their device, etc. Everyone with diabetes can reap the benefits of comfortable, alternate site testing.
Switching to alternate site testing returns tactical sensation within 2-3 months, as well as curing bruising and callouses, within 5 weeks.