Diabetic neuropathy

[Julie-F]

  I am 26 years old and have had Type I diabetes for 8 years. I also have
  hypothyroidism (7 years)as a result of radioactive iodine treatment from
  Graves disease. About 2 to 3 years ago I had shingles which was mostly in
  my left upper-outer thigh. I have recently been having problems such as
  tingling,along with chill bumps(without being cold & only in certain spots
  not covering the whole leg),& some pain,both affecting the same left outer
  thigh and back of my left calf. Both my primary physician and my endocrino-
  logist suggested that it was neuropathy. I was put on Elavil(25mg). This
  helped the pain, but I continuously have this tingling along with the chill
  bumps. I am swithching to Humalog insulin(Dr. prescribed) in hopes to get
  better blood sugar results. My readings are not outrageous but not perfect
  either. I am a" brittle" diabetic I think they call it and am on an insulin
  pump. My question is-is this truely diabetic neuropathy and if so is the
  Elavil an adequate treatment for it? I've heard of the pain and tingling,
  but not the chills in just certain spots on the leg. It is very uncomfort-
  able and I would like some input, and maybe recommendations. Thanks in
  advance for any help and opinions you may offer.
  sary.

[CCF Neuro MD MJD]

Tingling, Cold, Numbness and increased sensitivity to touch are common symptoms of peripheral nerve disease (affecting nerves in the limbs).  And the most common cause of nerve disease is indeed diabetes.  Diabetes can affect the nerves in a number of ways - most commonly affecting the nerves in the hands and feet with sensory loss, tingling and numbness.  It can affect the nerves higher up (e.g. in the thigh) but often with a rapidly progressing weakness, pain and loss of muscle bulk.  Note also that hypothyroidism when not controlled can also affect the nerves.
But I notice that you describe this tingling in the region where you had shingles.  Prior to another shingles attack, people often feel sensory changes before thge rasdh develops.  But even without recurrence of the rash, people do report sensations like tingling or even pain in the regions affected.
Regarding your treatment:  If this is diabetic neuropathy, the best therapy is control of your sugar.  Progression of nerve disease is slower in those whose sugar control is best.  As for symptomatic treatment of any pain or tingling you may be having, a variety of medications are used known for other treatments.  Elavil and other Antidepressants are used as well as antiepileptics like Carbamazapine.  Don’t be uopset if one medication doesn’t work - there are a number that can be tried
Hope this was of help. Remember, this information is for educational; purposes only and should never substitute for evaluation by a physician for diagnostic and therapeutic options.