Diabetic amyotrophy is also known as proximal diabetic neuropathy. It is a disorder stemming from diabetes mellitus complications.
Its negative effects are most notable on the thighs and lower legs, hips and buttocks and they include wasting or weakness in muscles, pain, numbness or other aberrations in sensation. These problems come from neural damage most often caused by diabetes.
Diabetes damages the nerves in several different ways, but all of them come from the same source which is increased levels of blood sugar. Being one of four different types of diabetic neuropathy, diabetic amyotrophy is more common with the patients suffering from type 2 diabetes mellitus, although it is not impossible for it to occur with type 1 diabetes patients.
It is important to note that not only diabetes patients can suffer from diabetic amyotrophy, although they are the vast majority. The nerve damage can also come from various immune system mechanisms.
Diabetic amyotrophy symptoms
The first sign of diabetic amyotrophy is usually pain in legs, thighs, hips or buttocks. It is usually more prominent on one side of the body. Sometimes the pain is sudden while in other cases its severity increases over time. The increase in pain is followed by increased muscle weakness, especially within the lower limbs.
This weakness comes from denervation of muscles which are usually innervated by the plexus regions affected by diabetic amyotrophy. The same issue can cause muscle contractions. It is caused by the damage of the blood vessels whose job is to supply the nerves in the legs.
The symptoms can be very severe and even bring the need for wheelchair use in some cases. They can also last from about several months to several years and many patients never recuperate completely. In these cases patients will usually not feel significant pain, but mild weakness can linger.
Diabetic amyotrophy diagnosis
The first signs are hip and thigh pains and muscle weakness in the same area, while suffering from diabetes is also a sign. In order to diagnose diabetic amyotrophy without doubt, electrodiagnostic studies are often used. The most common ones are nerve conduction studies and electromyogram.
In order to exclude other conditions with similar symptoms, many doctors opt for lumbar puncture to check for spinal cord fluid inflammation and MRI scan to check if the nerves found around the spine are compressed.
Diabetic amyotrophy treatment
For the patients who suffer from type 1 or type 2 diabetes, and this is the vast majority of those affected by diabetic amyotrophy, it is very important to keep good control over diabetes. This includes diet management and stopping smoking.
Since muscle wasting is an issue, it is essential to keep being active and do this under professional control, so most patients opt for physiotherapy. Keeping muscles active helps with slowing down the wasting and also speeds up recovery.
Speaking of medication, some kind of painkillers is necessary to help both reduce pain and enable patients to be active. Other drugs include antiepileptics and antidepressants. More novel options include immunosuppressants and steroid medicines which are thought to help recovery. However, their effects are still being tested to prove efficacy in all cases.
Most patients will recover in time and the duration of the treatment depends on the severity of the damage to the nerves. Having in mind that permanent damage is preventable in vast majority of cases, it is very important to manage the symptoms efficiently and thus slow down deterioration and perpetuate recovery.
Palmitoylethanolamide (PEA) is another treatment option for patients suffering from diabetic amyotrophy and it is the one with the widest range of benefits. They come from the only ingredient of PEA, which is palmitoylethanolamide, an endogenous fatty acid made to protect cells and relieve pain and inflammation.
This should be enough to make PEA interesting for people suffering from diabetic amyotrophy. Managing pain is very important and PEA does so by affecting the iNOS and COX-2 expression, as well as neutrophils influx. The pain managing feature comes from PEA’s natural effects on the body’s endocannabinoid system.
There are other ways of managing pain, such as painkillers, but, as we all know, they come with a number of downsides including bad side effects, negative interactions with other drugs and habituation which calls for increased dosages to achieve the same effect and increases side effects.
PEA, on the other hand, is completely safe and it can be used alongside painkillers, since there are no negative interactions or replace even them completely. Many patients opt to take both painkillers and PEA until PEA’s levels in the body build up and take over the pain relieving function.
Also, there are no side effects whatsoever. This amazing feature has been proven in more than 400 medical studies and it is even clearer when we have in mind that PEA is consisted of a simple fatty acid which is easily broken down inside the body.
Moreover, PEA binds directly to the receptor called GPR119 which is used to regulate the secretion on incretin and insulin. This makes it very important for patients suffering from diabetes.
PEA also affects mast and glial cells. The former play a big part in our immune system and PEA’s effects on it help keep inflammation under control, which is very important for a wide variety of issues including diabetic amyotrophy. Glial cells, on the other hand, protect the nerve cells and promote formation of myelin. They protect nerve cells and make them healthy and well-functioning. This protection of nerve cells and control of the immune response make PEA invaliuable against diabetic amyotrophy.