If you live with diabetes, you may be familiar with complications such as heart disease, stroke, blindness, kidney disease, and lower limb amputations (to name a few). But you may not be as familiar with a disorder of diabetes nerve damage called diabetic amyotrophy.

This rare condition acts differently from other types of neuropathy (nerve damage).

This article will outline what you need to know about diabetic amyotrophy and what to do if you’re diagnosed with this diabetes complication.

Diabetic amyotrophy is a rare form of diabetic neuropathy, or nerve damage.

It’s also known by other names:

  • proximal diabetic neuropathy
  • diabetic lumbosacral radiculoplexus neuropathy
  • Bruns-Garland syndrome
  • femoral-sciatic neuropathy of diabetes

This complication is rare, affecting only about 1% of adults with diabetes. It’s less common in those with type 1 diabetes. It’s also more likely to affect men.

This diabetes-related complication causes pain and muscle wasting in the hips, thighs, buttocks, and legs. Occasionally, it may also affect the chest and abdomen.

Typical diabetic neuropathy is much more common, with at least 50% of all people with diabetes experiencing it at some point.

However, diabetic amyotrophy is not as common. It also affects a much wider area of the body and does not typically cause weight loss.

Contrary to popular belief, this type of neuropathy even affects people with well-managed diabetes. This is different from diabetes-related neuropathy, which is often caused by long-term high blood sugar levels.

Both conditions have the potential to cause discomfort and severe health outcomes. They both require a medical diagnosis from a healthcare professional.

The symptoms of diabetic amyotrophy include:

  • pain and numbness in the affected areas
  • stomach pain
  • weight loss
  • weakness in the muscles over time (muscle wasting)
  • eventual difficulty with standing up

Foot drop is a symptom of diabetic amyotrophy

People with diabetic amyotrophy may also develop foot drop (or drop foot), where the front part of the foot drags on the ground when walking due to nerve problems in the legs. About two-thirds of people experience these symptoms on only one side of their bodies. However, the condition can progress to the other side of the body as well.

The condition usually lasts several months, but it can linger for up to 3 years. By the end of this time period, most people have typically recovered, although not always completely.

Symptoms may be severe enough that some people will need to use a wheelchair.

Diagnosis for this condition is usually done through a process of elimination.

If your doctor thinks that you may have diabetic amyotrophy, they may refer you to either a neurologist or another diabetes specialist for more testing. Those additional tests may include:

  • a lumbar puncture to look for signs of inflammation in the fluid around the spinal cord
  • nerve conduction studies to check the nerves of the legs
  • an MRI scan of your lower back, to rule out compression of the nerves around the spine

Your muscles may also be examined for weakness and wasting, with special attention given to your leg reflexes.

Your medical team may order a complete blood count (CBC) panel. Other lab tests may also be ordered to specifically check for vitamin deficiencies and folate, vitamin B12, thiamine, and copper levels.

Because diabetic amyotrophy is a diabetes-related complication, your A1C levels and overall diabetes management will likely also be reviewed.

While diabetic amyotrophy usually does not require treatment, a few interventions may help alleviate painful and uncomfortable symptoms:

  • Controlling blood sugar and closely monitoring diabetes management: Work with your diabetes care team if you feel that you need to modify the diabetes medications you’re taking, change your diet, or add more exercise into your routine.
  • Taking medication like Gabapentin and pregabalin for pain relief: These prescription medications may help reduce long-lasting nerve pain. Over-the-counter pain relief can be an option as well, like acetaminophen or ibuprofen.
  • Alternating with ice packs or heating pads: This process may temporarily relieve pain. Epsom salt baths are also recommended.
  • Transcutaneous electrical nerve stimulation (TENS): This is a device like Quell, which is completely automated neurostimulation technology. The device wraps around your calf, providing stimulation and reducing pain. This small device can be worn 24 hours a day and has helped many people deal with chronic pain by blocking the body’s pain signals from reaching the brain.
  • Spinal cord stimulation: The Food and Drug Administration recently granted approval to Nevro Corp., to release their newest pain relief system called Senza or “HFX”. This technology focuses on spinal cord stimulation technology. This is now the first FDA-cleared implantable device that is also drug-free to treat chronic pain. This device is implanted in your body and is placed near your low spine. The mild electrical pulses are delivered to your spinal cord when needed, for relief that can be felt anywhere from the arms, legs, feet, and toes. These pulses are aimed to calm inflammation of the nerves and reduce the pain signals interpreted by the brain.

Yes, physical therapy can be key in helping to improve and maintain muscles weakened and damaged by diabetic amyotrophy.

Physical therapists can teach you helpful exercises to strengthen your affected muscles. Occupational therapists can recommend adaptable devices, such as reachers, raised toilet seats, or stools to help make daily activities easier and to alleviate pain.

While most people will benefit from these therapies and gain much of their strength back, improvement doesn’t happen right away.

Recovery can take years, but in many cases, there may not be a complete recovery.

Diabetic amyotrophy is a rare diabetic nerve complication that only about 1% of adults with diabetes are diagnosed with. It’s a painful form of neuropathy that mostly affects the thighs, buttocks, hips, legs, and sometimes the chest and abdomen. This complication may also cause pain and muscle wasting, lasting anywhere from several months to years.

Diabetic amyotrophy is not solely caused by prolonged high blood sugar levels. Even people with well-managed glucose levels can develop it. It’s more common in men and in people with type 2 diabetes. Treatments range from over-the-counter and prescribed pain medications to spinal cord and transcutaneous electrical nerve stimulation.