Diabetic proximal neuropathy is only one of many diabetic neuropathies. Like all the others it is the result of long-term high blood sugar, but it is not as well known as the numbness and tingling of fingers and toes that is called peripheral neropathy. Nearly every type 2 diabetic will experience it.
But not everyone with type 2 diabetes has the symptoms of muscle wasting and weakness that is diabetic proximal neuropathy. This condition is also called diabetic amyotrophy (myo- for muscles and -trophy for breaking down), and it happens after years and years of too much glucose in your blood.
The Symptoms of Diabetic Proximal Neuropathy
Diabetic amyotrophy starts with pain in the muscles of the thighs, hips, buttocks or legs. In rare cases it also affects the shoulders, but wherever it shows up, the pain is usually on only one side, or on one side more than the other.
If the cause of the muscle wasting is diabetic nerve disease, it is always in older adults who have had diabetes for a while. Type 2 diabetes has usually been damaging the blood vessels that supply nerves with oxygen, destroying the nerves slowly over time.
The effect is weakness in your legs, being unable to stand up from a chair without help. There is loss of knee and ankle reflexes too. That's one reason doctors check your reflexes at each physical by gently tapping your knee and ankle joints with a small hammer.
If diabetic proximal neuropathy continues, the result is quadriparesis, or weakness in the arms and legs. That's why it is called muscle wasting. There are other causes for this disease, such as Lou Gehrig's disease or muscular dystrophy.
But in type 2 diabetes the cause is peripheral nerve disease. Insulin resistance in the cells leads to high blood sugar that weakens veins and arteries, as well as high insulin levels that lead to inflammatory symptoms. For a long time those are hidden problems, but after a while the symptoms of pain and weakness rise up, and we are forced to face diabetic amyotrophy.
How Is Diabetic Proximal Neuropathy Diagnosed?
Doctors have tests available to them – nerve conduction studies and needle electromyography are two of them – but usually the tests are not needed. It is easy for your doctor to see the symptoms of amyotrophy by use of reflex testing and observing how you stand and walk.
The diabetic neuropathies your doctor sees every day make diagnosing very easy. It's the treatment and prevention that concerns them the most, and it's good to know there are things that can be done.
Diabetic proximal neuropathy is halted and reversed by controlling your blood sugar. Using good eating habits is a great start for lowering your blood sugar. Then there is physical exercise that not only aids blood sugar control but strengthens the muscles and stimulates nerve growth.
There are medications for helping control blood sugar, too, but you need to be aware of the side effects of each diabetic medicine so you can weigh that against the positive results. You can also look into medications for nerve pain, most of which are similar to the things doctors prescribe for depression. That's because those medicines have been found effective against nerve pain.
What that means to me is if you can stay out of the depression that plagues diabetics and work on good mental health, nerve pain will be less damaging. Avoiding harmful habits like smoking, and lowering your levels of stress will also aid you in the fight against neuropathies.
If diabetic proximal neuropathy has made it difficult to get around there are good physical therapies for bringing feeling back in your legs and building muscles that have weakened. For a type 2 diabetic there is always hope because, unlike other wasting diseases, this condition responds to intervention with exercise, weight loss and physical therapy. You can slow and reverse the course of diabetic amyotrophy.
I know how hard it is to face pain. I'm afraid I do not do it very well. But if we will go ahead and walk through the pain we will get stronger and feel better. It's the only way to keep those peripheral nerve disease symptoms from taking over our lives. Let's do it.