Diabetes Mellitus: Types of Neuropathies

Patient

Q: I have neurapathy to the extent that I believe my muscle loss is effecting my muscles from supporting my body frame. I've had good glucose levels for 10 years. Can neurapathy get to the point of a person not walking or being bedridden?. Also does neurapathy affect the heart muscle. My weight is within normal limits. 200 Lbs, 6 ft. tall. It even hurts to raise my arms. My neurologist says it's the worst neurapathy he has ever seen. I've had multible emg's , but I;d really like to know if my heart muscle could be effected by neurapathy. Thanks so much for this invaluble service. Kenneth Barrow

Doctor

A:   Indeed, neuropathies are the most common complication of diabetes mellitus (DM), especially type 1(insulin-dependent). Neuropathies related to DM affect up to 50% of diabetic patients. The nerves and muscles in the diabetic patient are affected because the high levels of glucose circulating in blood, that’s why it is very important to keep a strict control of glycemia at all times to avoid continued deterioration. The loss in muscle mass is due to the problems in the nerves that control the muscles and it is called Diabetic Amyotrophy which affects the muscles of upper and lower extremities and leads to muscle atrophy and weakness. And to answer your question, the diabetic neuropathy, in the same way that affects the peripheral nervous system (PNS) nerves, also may affect the autonomic nervous system (ANS) nerves that are involved in the cardiac functions, like heart rate control and vascular dynamics, this is called: Cardiovascular Autonomic Neuropathy (CAN).

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