From America On-Line:
I have a 14 year old son who was diagnosed with Diabetes nearly two years ago. In addition, he has been experiencing back pains for approximately 1 1/2 years. He has had a number of different tests and was told he has fibrosis dysplasia. However, more recently has been having additional back pain in the lower back (it started up by the shoulder blades). He came across this condition called Diabetic Myelopathy and we were hoping you would give us some information.
Diabetic myelopathy (sometimes called diabetic amyotrophy) is an uncommon and little understood complication of both Type 1 and Type 2 Diabetes. It was originally documented in relation to very poor control over an extended period and the one case reported in a teenager belonged to this category. Other cases have been attributed to changes in the arterial supply to segments of the spinal cord and finally there is some evidence that the syndrome may reflect an associated but distinct autoimmune disorder, rather like hypothyroidism and the celiac syndrome.
Clinically there is usually a combined sensory polyneuropathy with a loss of position and vibration sense together with what is called a pyramidal or upper motor neuron type loss of muscle power especially in the thighs and pelvic muscles. The prognosis is not good.
From the history you give, I think it very improbable indeed that this condition is the cause of your son's back pain. Despite the single report, he is very young to be affected and also has had diabetes for too short a time. Finally his symptoms do not fit the pattern of those described for myelopathy.
I would wonder how he came to enquire about this very uncommon problem because it does seem possible that his back pain, at least in part, may be due to some special anxiety about the long term complications in diabetes. If there is a Medical Social Worker in his Diabetes care team, who as experienced with this age group, it might help for her/him too explore this possibility and to try to disentangle any underlying psychosocial issues.
Additional Comment from Dr. Lebinger:It is highly unlikely that your son's back symptoms are related to his diabetes. He is in a period of active growth and probably high activity level. I would strongly suggest that if you haven't yet consulted with a Pediatric Orthopedist that you do so to rule out a subtle injury or congenital malformation of the spine.
Original posting 12 Dec 97
Last Updated: Tuesday April 06, 2010 15:08:54
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