Calloused, Hyperpigmented Fingertips

A 70 year old woman with long standing type 1 diabetes presented with calloused and hyperpigmented fingertips due to decades of frequent fingerstick glucose testing. Despite achieving a glycated hemoglobin level of 6%, her diabetes was complicated by chronic kidney disease, neuropathy, and severe retinopathy. The case underscores the need for regular reeducation in diabetes self management, even for experienced patients. Recommendations included using the lateral sides of fingers for testing, changing lancets frequently, adjusting insertion depth, relaxing glycemic targets, and considering voice enabled continuous glucose monitoring. The patient was lost to follow-up.

A 70 year old woman with long standing type 1 diabetes presented with calloused and hyperpigmented fingertips due to decades of frequent fingerstick glucose testing. Despite achieving a glycated hemoglobin level of 6%, her diabetes was complicated by chronic kidney disease, neuropathy, and severe retinopathy. The case underscores the need for regular reeducation in diabetes self management, even for experienced patients. Recommendations included using the lateral sides of fingers for testing, changing lancets frequently, adjusting insertion depth, relaxing glycemic targets, and considering voice enabled continuous glucose monitoring. The patient was lost to follow-up.