Patient: I cant seem to clinch my fist and it is in pain. Could this be related to heavy drinking?
Doctor: Besides your heavy drinking you have another factor that might be related with your problem, which is the Diabetes. Ind deed, 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. Also, 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).