Re: Diabetic neuropathy

Posted By CCF NSG MD /gsh on September 22, 1998 at 08:23:40:

In Reply to: Diabetic neuropathy posted by Julie F. on September 22, 1998 at 01:38:22:






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.
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Dear Julie,
Peripheral neuropathies are classically described as a 'stocking and glove'
distribution of numbness and tingling.  The long-term complications from diabetes
are really problems due to impaired microvascular circulation.  Tight control
of blood sugars can slow the progression of this ultimately microvascular disease,
but not prevent them.  
Your symptoms are not typical for a peripheral neuropathy in that your pain
and numbness are in the lateral aspect of the leg and in the calf.  You may
have some residual effects from the episode of shingles last year.  Elavil
may provide some relief and is a reasonable start.  If this doesn't work your
physician may consider Tegretol or a similar medication to help with your pain.
Sometimes in these situations a physician may try a number of different medications
to find the one that works best.  Each patient is different.
Try to have some patience, but give the medicine a shot.  Remember that tight
control of your blood sugars will benefit you in the long run with diabetes.
Good luck.