Type 1 diabetic: fingers fall asleep

Patient: I have been a type 1 diabetic for 18 years. My a1c is around 8 but varies. recently, every time i sleep when I put my hand up under my pillow it goes numb. This never happened in the past and it happens with both hands. If i touch the back of my neck with my hand for 10 min it will go numb and feels tingly. Last year, around this time, my legs were very itchy and developed brown spots.Is this due to poor blood circulation and can it be reversed? Is there a difference between neuropathy and poor blood circulation?

Symptoms: Tingling and numbness in fingers when I lift up my arm and especially when i bring my hand behind my neck.

Doctor: HelloWelcome to Ask The Doctor.You seem to be suffering from Nerve compression.This is not due to diabetic neuro pathy as it starts from lower limbs and hands and is bilaterally symmetrical.I would advise you to get an X-ray Cervical spine to rule out any disc prolapse.For acute muscular pain I advise following:1. A combination of pain killer and muscle relaxant containing Diclofenac and Thiocolchicoside.2. To do hot fomentation of the affected area.3. To apply Diclofenac ointment locally.4. To get physiotherapy done particularly Ultrasonic heat massage.Your pain would start getting better in 5 days.If any disc prolapse is found you would be treated with a combination of Pregabalin and Methylcobalamin.Share my opinion with your doctor before you act upon it.I hope this helps.Stay Healthy.