Fibromyalgia and diabetes: Lab tests essential in diagnosing the difference

Main symptoms of diabetes

Fibromyalgia and diabetes have many of the same symptoms. That's why it's important to have a comprehensive examination in determining the differences. Learning from experience can be the hard way, so here are some tips to help prevent a problem of diagnosis and treatment with these conditions.

As a life care planner and counselor I had many opportunities to interact with clients with their doctors in preparing case material or providing guidance. I also had personal experience with health conditions that helped me learn that medical diagnosis is not a perfect science, so the patient needs to be vigilant and informed. That's particularly true because certain conditions can
produce similar symptoms; and if the right one is not treated, serious harm to a patient can result. My personal story reflects these issues.

I experienced chills and sometimes what I thought were hot flashes at night. I felt lethargic intermittently throughout the day. Sometimes I would have to sleep in my chair at work in order to get through the work day. My feet had small red sores around the toes that sometimes burned, and I had fungus under my toenails I had for years. My face would break out in red patches around the nose and across the forehead. I had fungal infections on my feet and terrible itching. I would frequently ache all over. I had sleep problems and often felt depressed for no reason. During my young adulthood, prior to menopause, I suffered from painful menstrual symptoms. I did not have frequent thirst, but as I was to learn later, this may be a primary symptom but is not always present with diabetics, as diagnosis is based upon a cluster of symptoms, blood sugar problems.

After visiting a rheumatologist, I was diagnosed with fibromyalgia. This was before the present set of medications specifically for the condition. I took medication for sleep, to bring down inflammation, and to help mood. A podiatrist prescribed a special cream for my feet, and a general physician recommended special shampoos and face creams. But the lethargy, aching, and major symptoms remained, although somewhat minimized as I went from doctor to doctor for treatment. But none tested my blood sugar.

After suffering debilitating headaches, on top of other symptoms making it difficult to function, I went to a doctor for assessment and tests. This doctor asked for medical records but said because diagnoses can sometimes be incorrect, she would do complete screening for certain conditions that mirrored fibromyalgia. One of these conditions was diabetes.

When the results came back from testing, I learned I am diabetic. After being placed on diabetic medication and following a regimen of low carbohydrate foods, I found my symptoms all but disappeared. But some of the side effects from long-term diabetes had already caused nerve damage. Had doctors done more thorough lab tests and regular evaluation of symptoms, perhaps there might be a difference in the present outcome of my condition.

My story is one among many people who have treatable conditions not properly diagnosed or where doctors made medical conclusions based upon a particular orientation, specialty or interest of the time. In my case, I had visited specialists in rheumatology, orthopedics, and gynecology whose focus was outside the area of diabetes when an internist trained in working with diabetics may have been sufficient.

These are the symptoms in the conditions of fibromyalgia according to Web MD:
 Anxiety
 Concentration and memory problems
 Depression
 Digestive disorders
 Discoloration of hands and feet (Raynaud's phenomenon)
 Dryness in mouth, nose, and eyes
 Fatigue
 Headaches
 Irritable bowel syndrome
 Morning stiffness
 Pain
 Painful menstrual cramps
 Sleep problems
 Swelling, numbness, and tingling in hands, arms, feet, and legs
 Urinary symptoms
Physicians also maintain people with fibromyalgia have more yeast infections and depression than those without the condition.
Symptoms of diabetes from this same resource
 Excessive thirst and appetite
 Increased urination (sometimes as often as every hour)
 Unusual weight loss or gain
 Fatigue
 Nausea, perhaps vomiting
 Blurred vision
 In women, frequent vaginal infections
 In men and women, yeast infections
 Dry mouth
 Slow-healing sores or cuts
 Itching skin, especially in the groin or vaginal area

It has been found people with diabetes are twice as likely to suffer from depression as non-diabetics. As has been noted earlier, fibromyalgia patients are often seen with depression. Research has also established sleep problems to be frequent among diabetics. Skin complications are one of the concerns, and low blood sugar can cause headaches. Digestive problems can be part of the condition of diabetes as a result of nerve damage. This is also one of the hallmarks of fibromyalgia as well.

The value of having a complete diagnosis, to include lab tests, is critical in preventing wrong diagnoses where the patients end up having complications, which is often the case with diabetes. Given the symptom parallels in diabetes and fibromyalgia, that patients and even their doctors may not properly assess, the information about both conditions can be of consequence in addition to undergoing comprehensive evaluation to include testing blood sugar. This can often be the definitive explanation for certain symptoms that can put the patient on the right track for getting help and prevent serious side effects from developing, as is the case with diabetes.

Diagnostic errors in medicine more widespread than thought

Doctor's office where diagnoses occur

Leanne Jenkins--Mistakes happen; we all say that.  But when they are medical mistakes in diagnosis, some people die while others live in misery with illnesses that are treated incorrectly.  So what are the issues with regard to diagnostic problems, and what is being done about them.

Kaiser is one of the large medical groups that has recently observed the importance of getting correct diagnoses and acknowledges that nationwide many deaths and long-term disabilities are caused by physician error.

This year the New York Daily News reported about a woman in New York City who died as a result of multiple medical errors and a delayed cancer diagnosis that spanned a two-year period.  She reported in February 2010 chest pain and went to an emergency hospital room where she was told she had an asthma condition, after an x-ray had been done.

During the next two years the woman was treated by doctors who never looked at the x-ray.  She was back eventually at the same hospital, and it was at that time the x-ray was finally examined.  She did not have asthma but lung cancer in its final stages.  The woman died, and her life could have been saved had the x-ray been examined two years earlier.

In another case a woman was treated for fibromyalgia and what some doctors maintained was an systemic inflammation.  No one suggested a diagnostic workup for diabetes, despite the fact the woman had indicated that with the condition she often suffered fatigue in the mid afternoons.  Fibromyalgia pain is similar to peripheral neuropathy, and fatigue can occur when blood sugar drops, often about two hours after a meal, which would be the mid afternoon.  By the time she was diagnosed with diabetes, she already had glaucoma and other conditions related to diabetes.  Had she been diagnosed earlier, some of these problems could have been alleviated earlier than they were.

These stories are similar to many people, according to Kaiser reports.  The medical group tells us that wrong diagnoses occurs far more often than people think.

In 1991 surveys revealed that 14 percent of all adverse medical events happened as a result of wrongful diagnoses.  Many of these occurred as a result of doctors failing to look at the results of tests that had been ordered.

When errors occur, often doctors don't find out, and the blame for the resulting problems can be shifted to others.  Many of these errors also go unreported.

These are the facts as outlined by The National Center for Policy Analysis:
- 40,500 diagnostic errors that are fatal occur in intensive care units within American hospitals every year.
- Diagnosis errors are more common than errors involving medication and surgery mistakes, affecting 10-20 percent of all medical cases.
- A 2009 study involving 538 diagnostic errors showed that 28 percent of those errors were fatal, caused permanent disability or threatened the life of the patient.
- Many patients fail to take legal action, making it difficult to estimate how many people are victims.
The problems continue because of the culture of blame and the reluctance to report errors.  In order to reduce legal costs in the United States, as well as medical costs, experts remind us how important it is to reduce the errors.  This can be done by both patient and doctor becoming vigilant and the medical professionals willing to take responsibility for the mistakes instead of covering them up or blaming something or someone else.