NeuroTalk Support Groups - Diabetic PN and Nutrition

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Diabetic PN and Nutrition

Additional causes for distal sensory polyneuropathy in diabetic patients.
PMID: 16484643 Mar 2006

Quote:

OBJECTIVE: To assess the frequency of additional causes of distal sensory polyneuropathy (DSP) in patients with diabetes mellitus (DM). METHODS: Retrospective review of patients with DM and DSP during a 5 year period. A quantitative sensory score (QSS) was determined at the initial evaluation and extensive laboratory and EMG studies were performed. Patients with one or more potential causes for DSP were compared to those with DM alone. RESULTS: Fifty five patients (53%) had potential additional causes for DSP. These included: neurotoxic medications (seven), alcohol abuse (six), and B12 deficiency and renal disease (four each). The most common laboratory abnormalities were: abnormally low levels of vitamin B6 (11) or B1 (10), monoclonal gammopathy (eight), and hypertriglyceridaemia (eight). Twenty six (25%) subjects had more than one additional cause. Nine (9%) had three or more demyelinating features on EMG. There was a trend toward a lower QSS score (p = 0.05) and reduced mean amplitude of the sensory potentials in those with additional causes. Those with additional causes more often had upper limb sensory symptoms (p = 0.001) and sensory findings (p = 0.003). CONCLUSION: There was a high frequency of additional sources of DSP in patients with DM. These patients more often had sensory symptoms and findings in the hands. Tests that may be useful in the evaluation of DSP in diabetic patients include measures of vitamins B1, B6, B12, serum triglycerides, and immunofixation.
PMID: 16484643

I wonder what the low cutoff for B12 was for this study? We know that the cutoff of 200 is set way too low. What about B1 and B6? Are the "normals" for these set too low too?

It seems that often when a doctor finds diabetes they don't look any further for a cause. When I was first diagnosed with PN, my neurologist tested me for DM more than once.

Wish this study mentioned gluten as a cause of PN. :rolleyes:
Anne

it is usual that if you have diabetes and neuropathy it is presumed you have diabetic neuropthy :rolleyes:

the truth is they have never been able to prove that high blood sugar does cause neuropathy .........

and it is well known that most oral diabetes drugs have neuropathy listed as a side effect

and there is a growing amount of evidence that genetically modified insulin can cause neurological problems like dystonia and MS in some people

I have toxic neuropathy and although I have been a type 1 diabetic for nearly 40 years the two are NOT related ........

I now have DNA test to show my neuropathy was caused by Organophosphate pesticide exposure

and when I finally got a doctor to take me off GE insulin and back onto beef insulin my neuropathy improved (and a lot of other problems disapeared overnight )

koz

Hi koz~

I notice you got stuck with the greater than three letter requirement for a username, too. I thought about jccc...lol.

You make a lot of good points. It happens all the time that doctors are quick to blame everything on the one thing they already know.

My mom and dad both had neuropathy. My dad's presumed to be due to his diabetes. My mom's presumed to be due to alcoholism. I tried to encourage vitamins for both of them...just to cover that base. My dad will take a multivitamin because his doctor says so, but no more. My mom is on a lot of vitamins because she has savvy doctor who understands most of the complications of alcoholism are due to nutritional deficiency. She also religiously takes the B12 I send her. My dad can't feel his feet anymore. My mom's neuropathy (tingling/stabbing/pain in feet..some in hands) is gone~ she had complained for several years about it.

It is sad to think that doctors often don't look to the many possibilities mentioned above, as some improvements could certainly be realized.

Cara