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Question:

I am a 73 year old male. Last year I became an insulin dependent diabetic. I keep my sugar level between 80-120. I have pains in my lower legs and a burning sensation on the bottom of my feet. My doctor says that it is because of the diabetes, but I am having my doubts about this since my sugar is kept at such a normal level. I wonder why I would be having these severe diabetic side effects: the pains in my legs are a constant source of great pain for me. I think maybe I should find someone who will look into this a little farther, this has been my doctor for years and I think becoming a bit complacent.

Answer:

You may very well have diabetic neuropathy. Studies have found as many as 15% of people with diabetes have neuropathy at the time of diagnosis. What this tells us is that most people have had diabetes for a few years before they were diagnosed. There are other causes of peripheral neuropathy besides diabetes, such as alcohol use, nerve degeneration syndromes, etc. Whether you know exactly what has caused your neuropathy or not, the real question is what can be done about the pain? There are a number of treatments for peripheral neuropathy, including over the counter creams made from green chiles, capsacain. It might help the burning sensation although it must be applied as many as 4 times a day. I have had only a few patients say that it helped them. Some people get relief from amitriptyline (Elavil), an depression drug. We have had really good success lately using Neurontin, an anti-seizure drug. The important thing to get from this discussion is that there are a number of treatments to try. Of course, I always suggest that people try good control first because in many people this will improve or resolve neuropathy symptoms. Sounds like your blood glucose levels are in good control, but you will want to check your Hemoglobin A1c to be sure. With blood glucose levels like yours, you should see a HbA1c less than 7%. If it is higher than that, you may be having high blood sugars after meals when you aren't looking and may want to work on those. Sounds like you have lost faith in your doctor and may want to try someone new, or maybe ask him to refer you to a neurologist who can help track down the cause of your neuropathy and make some recommendations for treatment; a diabetes specialist could also help you manage your neuropathy as well.

VV

Original posting 2 Mar 1999
Posted to Complications

  
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Last Updated: Tuesday April 06, 2010 15:09:02
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