About one percent of people with diabetes develop diabetic amyotrophy. Also, known as proximal diabetic neuropathy, this is a type of peripheral nerve disease. It is a complication of diabetes that affects the nerves, mainly affecting the thighs, buttocks, hips and calves. The symptoms that occur are the result of damage to these nerves in these areas of the body. While it is rare, all people with diabetes mellitus should be aware of diabetic amyotrophy so that they can know when it is time to see their doctor.
CAUSES OF THIS TYPE OF DIABETIC NEUROPATHY
Most of the people who develop this condition have type 2 diabetes and are over 50 years old. Men develop it more often than women. It is caused by nerve damage that can result from high blood sugar levels. Because of this, people with uncontrolled type 2 diabetes are at the highest risk for diabetic amyotrophy.
When blood sugar levels remain high over time, this can cause nerve damage throughout the body. High glucose levels over a long period of time can also cause problems with the way the nerves send signals throughout the body. In addition, capillaries can also be damaged by prolonged high glucose levels. These blood vessels are responsible for delivering nutrients and oxygen to the nerves. Without the proper nutrients and oxygen, nerves eventually become damaged.
POSSIBLE SYMPTOMS
Once symptoms start, they tend to progress over time. Then, over months or years, they gradually decrease. However, most people will continue to have at least some symptoms to some extent in the long term. The following are possible symptoms of this type of diabetic neuropathy:
• Sudden pain in the buttocks, hips, or thighs that can sometimes be severe
• Loss of reflexes in the lower extremities, such as the knee jerk reflex, when the doctor is testing your reflexes by touching your knee
• Unintentional weight loss
• Weakness in the legs that can make it difficult to get up from a sitting position.
• Loss of muscle tissue in affected areas, such as the thighs.
In most cases, only one side of the body is affected. However, in rare cases, the condition can start to affect the other side of the body. People with this condition tend to experience symptoms in the lower body, from the hips down. Pain is usually one of the first symptoms. It may not be serious enough when it starts to cause alarm, but it can become serious over time.
GET A DIAGNOSIS
To diagnose diabetic amyotrophy, doctors start with a complete medical history that includes evaluating how well your diabetes is managed. Taking an A1c blood test can inform your doctor about managing your blood sugar levels for about three months. If the test and other information indicate that your blood sugar levels have not been controlled, this can give you information about the cause of your pain, weakness, and other symptoms.
Two tests that may be ordered include electromyography and nerve conduction studies. Electromyography looks at the health of your muscles and the health of the nerves that are responsible for controlling them. This test involves the strategic insertion of fine needles into the affected muscles. Your doctor will look at a monitor to get information about the electrical activity of your muscle. You may be asked to flex the muscle being tested during the test.
In most cases, nerve conduction studies are done during the same visit. This test measures how fast electrical signals travel through a nerve. Instead of thin needles, this test uses patches that are placed over the nerves that are being examined. A monitor provides the doctor with information about the speed of nerve signals so that he can determine if there are abnormalities.
TREATMENT OPTIONS
Treatment for this condition is the same as treatment for peripheral neuropathy. There are different medications and therapies that can be helpful. In many cases, your doctor will prescribe more than one treatment to help control your symptoms. The following medications may be considered:
• Over-the-counter pain relievers may be recommended to reduce your discomfort. To help with pain related to inflammation, medications such as naproxen or ibuprofen may be recommended.
• Antidepressants can help with nerve pain.
• Anti-seizure medications affect your nerves to reduce associated pain.
• Topical medications, such as capsaicin cream, can be helpful in reducing pain. In some cases, a lidocaine patch can be used, as it can numb a small area that is especially painful.
Your doctor may also recommend different therapies for this condition. Physical therapy is common, especially if your weakness or pain is moderate to severe. This therapy involves different exercises that can improve your pain, mobility, and weakness. In some cases, occupational therapy may also be recommended if your symptoms make it difficult to carry out your usual daily activities. Other types of therapy that may be helpful include:
• Intravenous immune globulin and plasma exchange may be considered if physical therapy and medications do not reduce symptoms sufficiently. This therapy works to suppress immune activity.
• Transcutaneous electrical nerve stimulation can help with pain. It involves using different frequencies of a mild electrical current to affect your nerves.
PREVENTION METHODS
There is no way to 100 percent prevent this complication of diabetes. However, keeping your blood sugar levels under control can significantly lower your risk. The first step is to check your glucose levels regularly so you can determine if they are getting too high. You must also take all of your medications exactly as directed. If your treatment regimen doesn’t keep your blood sugar levels in the healthy range, talk to your doctor about making adjustments. Other ways to help maintain healthy blood sugar levels include:
• Exercise most days of the week to increase insulin sensitivity and allow your body to use blood glucose more effectively.
• Reduce your carbohydrate intake, and when eating carbohydrates, limit yourself to complex carbohydrates, as these will not cause a sharp spike in your glucose levels (examples of complex carbohydrates include whole grains, beans, and lentils)
• Eat more fiber to reduce how quickly your body absorbs sugar and digests carbohydrates to reduce blood sugar spikes
• Stay hydrated by drinking plenty of water to help your kidneys get rid of excess glucose.
• Eat smaller portions more often to better regulate your blood sugar levels.
• Keep your stress under control, as glucose levels can be negatively affected by excessive stress.
• Make sure you get enough sleep to ensure better insulin sensitivity
CONCLUSION
Diabetic amyotrophy can be disabling. Therefore, all people with diabetes should know the basics about this type of diabetic neuropathy. If you experience symptoms related to this condition, it is important to see your doctor immediately. There are treatments for this condition that can help alleviate the symptoms and progression of this complication of diabetes mellitus. If you found this article helpful, please share it on social media and post a link on your website.