Diabetes comes with lots of potential complications. Diabetic neuropathy, or nerve damage, is one of the most common. But there’s a rare type of diabetic neuropathy called diabetic amyotrophy. It affects just 1% of adults with diabetes and acts differently from other kinds of diabetic neuropathy.
Most of the time, diabetic neuropathy happens in the legs and feet. Diabetic amyotrophy, though, damages nerves in the:
- Thighs
- Legs
- Hips
- Buttocks
Sometimes, it also affects the chest and abdomen.
Diabetic amyotrophy is also known by these names:
- Proximal neuropathy
- Diabetic lumbosacral radiculoplexus neuropathy
- Bruns-Garland syndrome
Symptoms
In general, people with diabetic neuropathy have pain and numbness. But diabetic amyotrophy has unique symptoms, such as:
- Intense pain in your hip and thigh or buttock
- Serious stomach pain
- Weakness in your thigh muscles over time
- A hard time standing up
Most people have symptoms on only one side of their bodies. But more than a third of cases affect both sides.
People with diabetic amyotrophy may also get "foot drop" because of nerve problems in their legs. Foot drop is when the front part of your foot drags on the ground when you walk.
Causes and Risk Factors
It’s not clear exactly what causes diabetic amyotrophy. High blood sugar can damage your nerves. But even people with well-controlled diabetes (both type 1 and type 2) can get diabetic amyotrophy.
Being an older man seems to increase your risk, but it also happens to younger people.
Diagnosis
Diabetic amyotrophy shares some symptoms with other conditions. Your doctor will probably want to rule out problems like:
- Degenerative spine disease, which can lead to thigh pain
- Diabetic muscle infarction, which can cause pain and swelling in your thigh muscles
- Meralgia paresthetica, which causes tingling, pain, and burning in your thighs
Your doctor may do some of these tests to find the cause of your symptoms:
- Blood tests to diagnose diabetes or see how serious it is
- Spinal tap, in which your doctor takes some of your spinal fluid and tests it for signs of inflammation
- X-ray
- CT scan
- MRI
- Electromyography and other tests to see how healthy your nerves are
Treatments
Diabetic amyotrophy often gets better on its own over time. But these things can help relieve symptoms:
Tight diabetes control. One of the most important things you can do is to keep your blood sugar under control. Medication, diet, and exercise all play key roles in helping you do this.
Medications for pain relief. Gabapentin and pregabalin have been shown to ease long-lasting nerve-related pain. Some antidepressants may help as well.
Physical therapy. It can help you maintain and improve your muscles. In addition to exercises, your physical therapist may recommend devices, like reachers and raised toilet seats, to help you move more comfortably.
Most people with diabetic amyotrophy will get much of their strength back, but not right away. It may take a year to start getting better, but in most cases, full recovery is not possible.
