Diabetic amyotrophy is a rare complication of diabetes that impacts the nerves in the lower body, especially the hip and thigh. It can cause weakness, muscle loss, and debilitating pain, making it difficult or impossible to walk. Diabetic amyotrophy can come on quickly and last anywhere from a few months to a couple of years, but usually gets better by itself, often leading to a complete recovery.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298cc4d167-5b25-42b1-bda5-08c925ae2f42 This disorder is also known as diabetic lumbosacral radiculoplexus neuropathy, Bruns-Garland syndrome, and proximal diabetic neuropathy. The exact cause of diabetes-related amyotrophy isn’t clear, and this condition currently cannot be prevented.
Signs and Symptoms of Diabetic Amyotrophy Symptoms It affects only about 1 percent of adults with diabetes, mainly those with type 2 diabetes . Symptoms typically first appear on one side of the body and primarily impact the hip, buttock, and thigh. Symptoms include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629060aeb66-318b-47df-bfe6-8c0b7f6409d6 Severe neuropathic pain Muscle weakness Loss of muscle mass Decreased or no reflex response Difficulty walking or an inability to walk The pain can last for weeks or months, and weakness in the lower body often lingers after the pain has improved. Nonmotor symptoms may include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976294739f07f-35dc-4444-874a-2ea38981147d Significant weight loss Excessive or reduced sweating, known as hyperhidrosis and anhidrosis Diarrhea Constipation
Causes and Risk Factors of Diabetic Amytrophy Causes Most diabetes complications, including other types of nerve damage (neuropathy) , are associated with chronically elevated blood sugar levels.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f35eded2-9f50-4e9b-b211-ff2de20bd2ad Diabetic amyotrophy, however, may be less strongly linked to high blood sugar ( hyperglycemia ). It is more likely to affect people with well-controlled blood sugar, normal body weight, and shorter duration of diabetes. Some cases are seen shortly after diagnosis with diabetes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629558c147a-1ecb-48fa-bcac-1389284aac8d The condition is more common among older adults, and the average age of onset is 65. Some cases occur in people who have recently experienced significant weight loss.
How Is Diabetic Amyotrophy Diagnosed? Diagnosis It is not easy for clinicians to identify diabetic amyotrophy, since the symptoms overlap with other health conditions. A variety of tests are available to help inform a diagnosis, including blood draws, electrophysiologic tests, and MRIs, but there is no definitive single test available. Clinicians typically need to use a process of elimination to make a diagnosis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e3c44491-ff78-44c6-bbc6-e79d2216cf6e
Treatment and Medication Options for Diabetic Amyotrophy Treatment Diabetic amyotrophy often resolves without treatment. The condition is active for as little as a few months, or as long as two years, and patients often make a complete recovery. Small studies have suggested that steroids or immunosuppressants may be able to help combat diabetic amyotrophy directly, but most treatments focus on reducing pain and enhancing mobility.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f6d0f156-dfde-490a-b0e5-255e1676007b Blood Sugar Control Good blood sugar control is central to the treatment of most diabetes complications . This includes taking prescribed diabetes medications on schedule and keeping your A1C in your target range. Those goals will vary depending on your type of diabetes and your healthcare provider’s recommendations. Pain Management Neuropathic pain and discomfort can be difficult to treat, and pain from diabetic amyotrophy is no exception. Doctors may recommend medications such as:e60dc2a1-f33c-4a05-9b50-8e3e8e597629f6d0f156-dfde-490a-b0e5-255e1676007b Acetaminophen and ibuprofen Amitriptyline, an antidepressant taken at night that can ease pain and improve sleep Opioids, such as tramadol or oxycodone Other Support If chronic pain causes mental health issues such as depression or anxiety, selective serotonin receptor inhibitors (SSRIs) are a possible treatment. If mobility is an issue, physical therapy and assistive devices like a cane, walker, or wheelchair may be needed.
Lifestyle Changes for Amyotrophy Lifestyle Changes Chronic pain can make the tasks of daily life more difficult. Making tweaks to your routine and your support system can help.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293ffeca2b-237c-407e-95ef-ae0169a5800e Make healthy choices. Eating well, exercising regularly, and getting enough sleep all can help improve stress levels and physical pain. Ask friends and family for help. Asking for help isn’t a sign of failure. Let the people who care about you assist you while you regain better mobility. Seek mental health support. Medications are only one tool for anxiety and depression. A mental health professional, like a therapist or psychologist , may be able to give you a new perspective. Find support groups. Searching for chronic pain or diabetic amyotrophy communities online can help you find people who understand what you’re going through. Also ask your healthcare team if they’re aware of any local support groups.
Diabetic Amyotrophy Prognosis Prognosis and Outlook The prognosis for diabetic amyotrophy is usually good. Most people will regain the majority of their strength and be free of pain within 18 months of onset.e60dc2a1-f33c-4a05-9b50-8e3e8e59762927b29eba-a958-4f5e-9378-21b7d252c136 For some, however, nerve damage or muscle loss will have lasting effects, even after the amyotrophy itself has gone away. A minority of people will experience a permanent loss of strength, and about 10 percent still need a wheelchair two years after the onset of symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629cc7d15cb-5482-4889-b137-438f03cbbc79
Complications of Diabetic Amyotrophy Complications Diabetic amyotrophy resolves on its own, and usually does not cause lasting complications. But in some cases, serious complications may occur: Complete or partial paralysis of the lower body or all limbs Depression Anxiety Unnecessary spinal surgery (if the condition has been misdiagnosed)e60dc2a1-f33c-4a05-9b50-8e3e8e597629b27e5df2-9cb2-4941-abeb-f307645a549b
The Takeaway Diabetic amyotrophy is a rare neurological disorder that causes severe pain and weakness in the lower body. It predominantly impacts people with type 2 diabetes. The exact cause is unknown, and the condition can occur even in people with well-controlled blood sugar or newly-diagnosed diabetes. Diabetic amyotrophy typically resolves on its own within two years, and only a minority of people will experience lasting mobility issues. Managing blood sugar, taking pain relievers, and physical therapy may help alleviate symptoms. Assistive devices like canes, walkers, and wheelchairs can help with mobility.
Resources We Trust Cleveland Clinic: Neuropathic Pain Mayo Clinic: Chronic Pain: Medication Decisions Loma Linda University: 7 Warning Signs of Diabetic Nerve Pain Hospital for Special Surgery: Treatment Options for Hip Pain Harvard Health Publishing: Pain, Anxiety, and Depression
