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Diabetic Polyneuropathy is being Misdiagnosed in majority of Patients.

  A lot of Diabetic patients actually have C.I.D.P.

What Are Peripheral Nerves?

Peripheral nerves are like electric wires. They connect the spinal cord to the muscles and  sensory organs in the skin .

Types Of Diabetic Neuropathy

Diabetic neuropathy can be classified as generalized symmetric polyneuropathies (acute sensory, chronic sensorimotor, or autonomic) and focal and multifocal neuropathies (cranial, truncal, focal limb, proximal motor [amyotrophy], or coexisting chronic inflammatory demylinating polyneuropathy [CIDP]). Treatable neuropathies, including CIDP, monoclonal gammopathy, and vitamin B12 deficiency, should be excluded.


Polyneuropathy:
Is the commonest type of diabetic neuropathy. The feet get involved first. When the neuropathy progresses then symptoms ascend  from the toes to foot and gradually further  to the knees. Later the hands may get  involved. The symptoms of neuropathy are  always worse at night. The commonest symptom is numbness.

A
common feature of Polyneuropathy is coldness of the feet. Burning sensation in the feet.

Another symptom is excessive sensitivity of the feet to touch. Patients usually notice this at night when they find that the touch and pressure of the bedclothes on their feet is unpleasant. At times there is discoloration of the feet such that is red or paler than normal.

When severe, neuropathy will damage the sensory nerve fibers that tell the patient where their feet are and so they become unsteady when walking. This is worsened by weakness of the muscles in  legs and feet due to damaged nerve fibers .

Patients may think that the problems are being caused by the blood vessels having problems.



Diabetic autonomic neuropathy:   There is excessive sweating of the face brought on by eating. There may be erectile dysfunction. The patients may have swelling of the feet or legs and they may tend to pass out when getting out of the bed or after urination.

Which Diabetics Get Neuropathy?


Any one with or without insulin dependence may develop diabetic Polyneuropathy.

Tests For Neuropathy

When a doctor wants to confirm the diagnosis of neuropathy he will either arrange for the patient to be seen by a neurologist and/or request an EMG test. In the EMG laboratory neuropathy is tested for by applying small electrical shocks to the nerves and recording the activity from muscles or from the same nerve some distance away. Sometimes this test is accompanied by a fine needle being inserted in one or more muscles.


What Can Be Done About Neuropathy?

Diabetic neuropathy should be evaluated to exclude CIDP. If the patient has a high protein level in the spinal fluid. The EMG/NCV shows a neuropathy and the condition is progressive. Then they may have CIDP.

CIDP is treated by IVIg. Please read the IVIg page. IVIg will even get rid of the burning type of pain, the numbness and help improve strength. Patients have  even noted that they needed less Insulin AFTER they started to use IVIg. Recommended dose of IVIg is 2g/kg  per month in divided doses.

    IgG       

Other ways to treat diabetic neuropathy is to use a exercise bicycle pedals as seen in our link pages.

Regular exercise will help control a lot of symptoms.

Contact us for any help you need in getting treatment.

 

  emilyicon

 



Iron Will Trounces Neuropathic Pain

Statistics show that only .007363 percent of all Americans can complete the Triathlon.    Even more remarkable, on November 5, 2005, she finished the grueling Ironman Florida Triathlon just two years after being diagnosed with Parsonage-Turner syndrome, a rare type of neuropathy that causes crippling muscular pain.

You can get better too! Act fast get the treatment that can HELP YOU.

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CIDP

Below is a study done which documents what we are talking about:

Diabetic Neuropathy and  demyelinating polyneuropathy successfully treated with intravenous immunoglobulin

Intravenous immunoglobulin successfully treated patients with diabetes-related chronic inflammatory demyelinating polyneuropathy (DM-CIDP), according to authors of a report in the Archives of Neurology.

Evidence is growing that diabetes-associated CIDP shares many features with idiopathic CIDP. One of the standard therapies for idiopathic CIDP is intravenous immunoglobulin (IVIg). Therefore, K.R. Sharma and colleagues at the University of Miami School of Medicine treated DM-CIDP patients with IVIg to determine its efficacy.

In this prospective nonblinded trial, 25 patients, age 40 to 80 years (average 64 years), with type 2 diabetes and neuropathy that met the diagnostic criteria for CIDP, and 1 patient without diabetes, received daily IVIg (400 mg/kg body weight) for 5 days. A Neuropathy Impairment Score was obtained for each patient at baseline and again 4 weeks after the start of therapy.

A significant decrease from baseline in Neuropathy Impairment Score occurred by the 4-week follow-up (61.5 at baseline vs. 33.0 at 4 weeks; p<0.001), indicating substantial improvement in the condition of 21 of the 26 patients (Diabetic demyelinating polyneuropathy responsive to intravenous immunoglobulin therapy. Archives of Neurology, 2002;59(5):751-757).

Patients who experienced conduction block were significantly more likely to show an improvement in Neuropathy Impairment Score: all 11 of the 11 patients who experienced conduction block showed an improvement the score, while only 10 of the 15 patients who did not have conduction block demonstrated improvement (p=0.03).

Treatment side effects were relatively minor and included reversible kidney dysfunction (3 cases), flu symptoms (5 cases), headache (5 cases), and chest pain with shortness of breath (1 case).

Sharma and colleagues concluded, "Although IVIg therapy seemed to improve DM-CIDP in this uncontrolled trial, a controlled trial is required for confirmation of our findings."

The corresponding author for this study is K.R. Sharma, University of Miami School of Medicine M740, Department of Neurology, 

Key points reported in this study include:

* Patients with diabetes-associated chronic inflammatory demyelinating polyneuropathy (DM-CIDP) improved significantly after treatment with intravenous immunoglobulin (IVIg)

* Improvement in Neuropathy Impairment Score was significantly more likely for patients who experienced conduction block

* Side effects of IVIg treatment included flu-like symptoms, headache, reversible renal dysfunction, and chest pain This article was prepared by Pain & Central Nervous System Week editors from staff and other reports

 

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         We have seen patients go from wheelchair to walking with our treatment protocols.

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