天美传媒

Description

Diabetic amyotrophy, also known as proximal diabetic neuropathy, is a diabetic complication that affects the nerves that supply the thighs, hips, buttocks, and/or lower legs. A form of diabetic neuropathy known as proximal diabetic neuropathy is characterized by muscle wasting, fatigue, pain, or changes in leg sensation/numbness. Damage to the nerves of the lumbosacral plexus causes it. People with type 2 diabetes are more likely to develop proximal diabetic neuropathy. It's not as common as distal polyneuropathy, which is common in diabetics. The symptoms and signs of proximal diabetic neuropathy vary depending on which nerves are impaired. The pain in the buttocks, hips, thighs, or legs is typically the first symptom. This pain usually begins suddenly on one side of the body, but it can spread on both sides. Variable weakness in the proximal muscles of the lower limbs, such as the thigh and buttocks, is common. Numbness, tingling, and discomfort are the most common symptoms of diabetes, which are caused by damage to the long nerves that supply the feet and lower legs (diabetic polyneuropathy). While these signs may also be present, proximal diabetic neuropathy causes pain and weakness that develops more rapidly and affects nerves closer to the torso. This disease most often affects people with type 2 diabetes, but it can also affect people who do not have diabetes (nondiabetic lumbosacral radiculoplexus neuropathy). Endoneurial microvessel disease, in which cells that protect the endothelium (pericytes) are weakened due to high blood sugar, was believed to be the cause of the disease's nerve damage at first. Pericytes control capillary blood flow and can cause phagocytosis of cellular debris as well as nerve ischemia if they are impaired. Another possible mechanism is an immune response that causes microvasculitis, which can lead to ischemia. Diabetes treatment may help to avoid proximal diabetic neuropathy. In diabetics, the occurrence of proximal diabetic neuropathy is thought to be linked to blood glucose regulation, and it is likely reversible with better blood glucose control. Prescription medications may help with the pain associated with proximal diabetic neuropathy. Gabapentin and pregabalin are two popular medications used to treat diabetic amyotrophy since they directly target the nerve. Amitriptyline (also used to treat headaches and depression) is one of the most commonly prescribed medications for neuropathic pain. Duloxetine is an antidepressant that is often used to treat bladder disorders. Pregabalin and gabapentin are anti-epileptic drugs that are also used to treat headaches and anxiety. Although the anatomical and pathophysiologic mechanisms of diabetic amyotrophy are unknown, there is evidence of damage to peripheral nerves, nerve roots, and the lumbosacral plexus, as well as axonal degeneration, demyelination, inflammation, ischemia, and immune-mediated microvasculitis.