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February 7, 2003

Diagnosis and Symptoms, Research: Causes and Prevention

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Question from Jeffersonville, Indiana, USA:

Everyone in my family, except me, has/had diabetes, and, during my second pregnancy (at age 19), I had a number of problems (severe kidney infections, pleurisy, eclampsia, UTI, PID, hives, etc.), and my son weighed 10 pounds. Blood sugars at home and in the doctor’s office testing, occasionally showed very high levels, but lab testing always was consistently low. For the last 30 years, I have had increasing neurological symptoms, gastrointestinal and kidney problems, optic neuritis, and now I use a cane/wheelchair at times. I have skin rashes, infections, dry skin, frequent yeast infections, and poor bladder/bowel control, especially at night. I frequently have a low grade fever which occasionally shoot up as high as 104.8 F but has no explainable reason. I also have poor feeling in my pelvis and extremities and have been tested for MS, Cushing’s, lupus, etc.

My family does have problems with neuropathy (pain, numbness), and my mother and sisters had heart, kidney, and eye complications. We all have/had high blood pressure. The rest of the family has/had type 2 related to weight gain, and I have gained approximately 150 pounds in the last 10 years partly due to prednisone, less activity, and of course, food intake, but I was not obese until after age 40. I did gain 2-5 pounds a year since a hysterectomy and ovary removal at age 22.

I was recently sent to a new neurologist because of tremors and spasms that sometimes appear to be more a type of seizure, and he suggests that I may have had diabetes for up to 30 years. Is it possible that diabetic neuropathy has caused this? The doctor’s explanation makes sense, but how could the tests be so inconclusive all those years? Why would I have type 2 without weight gain and lack of exercise? Without a diagnosis, it is very hard to explain/work with an employer, and you certainly cannot apply for any type of disability/medicaid, etc. I have slowly cut back working hours over the last 10 years since I began having comprehension/memory problems (not good for a bookkeeper — so now I am a stay-at-home grandma).

Answer:

From: DTeam Staff

It is possible to have diabetes and not know you have it. All the while, the elevated blood sugars may have a negative effect on the nerves of the body. It is not rare to have someone already have neuropathy at the time of diagnosis of diabetes, and the neurologist would be in the best position to make the diagnosis. It is a clinical diagnosis, supported by history, physical exam, and neurophysiologic tests (like EMG). The neuropathy may respond to improved blood sugar control (by whatever means), medications, or it may go away with time.

JTL