Possible Diabetic Neuropathy ?

Patient

Q: Doctor, I seem to have a diabetis problem called Neuropathy. Numbness and extreme muscle loss from elbows down and knees down. I am also losing muscle all over my body. I've also lost 40-45 lbs. in the last two months. My neurologist says I have the worst Neuropathy he has ever seen. EKG's showed no conductivity in hands and right arm. I take 40 units of Novolog and 40 units of Levemir before meals, as needed. Is there anyway to rebuild or reverse the damage done. My AC-1's have been 6.5 to 6.9 for over 3 years but it just keeps getting worse. I am now losing muscle in my face, jaw, and neck.. My jaw muscles get sore when I eat. I tire VERY easily. Water seeps out of my right leg when I stand. Both my hands are stiff. I cannot straighten out my fingers to wave goodbye or cup both hands to splash water on my face My mother passed away in 2010 with the same symptoms and they said it was Parkinson's. She did not have diabetis. Is there any thing I can do? Every doctor has a different diagnosis. Thanks Ken

Doctor

A:   There are multiple causes of tingling and numbness of the extremities (hands and feet), as for example: vitamin deficiencies (Vitamin B12, B6, B1, folate or Vitamin E), nerve compressions at the level of the spine, alcohol abuse, problems with the peripheral nerves of hands and feet, lead poisoning and metabolic causes as problems with the Thyroid gland and Diabetes, which is one of the most common causes in western countries. I would advise you to get an appointment with an Internal Medicine doctor and confirm the Diabetes diagnosis and determine certainly that diabetes is the cause of your neuropathy. Neuropathies are the most common complication of diabetes mellitus (DM). 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. 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. There is no specific treatment for the peripheral neuropathy; the objective of the treatment is to control the pain and remove the underlying cause if possible to stop the progression of the nerve damage.

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