Diabetic Amyotrophy

A condition characterized by severe pain and muscle weakness in one or both thighs (and occasionally the arms and abdomen). It typically develops in people with Type 2 diabetes who are over 50, especially those who have not had diabetes for long or who have not yet been diagnosed. Doctors aren’t sure what causes it. It may result from a loss of blood supply to key nerves in the hips and shoulders, from the direct effect of high blood glucose levels on these nerves, or from a combination of both. Diabetic amyotrophy usually improves over time, though symptoms may fluctuate.

Amyotrophy may be treated with drugs to control pain. These include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, opioids such as codeine and morphine, and tricyclic antidepressants such as amitriptyline (brand names Elavil and others) and imipramine (Tofranil). Other drugs that may be useful include tramadol (Ultram and others) and gabapentin (Neurontin). Other measures that may help include improved blood glucose control and immunosuppressive therapy with corticosteroids or intravenous immunoglobulins.