Autonomic Laboratory
Patient Question, May 2000
This Web page is designed for the general education of patients and their families.
Disclaimer: The answers provided are the opinion of Dr.
Tom Chelimsky. No patient should make any changes in their care without
first consulting their physician.
Question: In the past three years, I have been diagnosed with diabetes, very atypical and difficult to treat...it doesn't go too high, my upper ranges have been in the 300's, HbA1C's have gone as high as 8.3, but started out at upper 6's to begin with. Since then, I have had been worn out and sick most of the time, pitting edema in my legs & pain in one leg which lead to a diagnosis of lumbar spinal stenosis radiculopathy & three blown lumbar discs. I have degenerative arthritis that is affecting other parts of my body now as well. I have strange muscle twitches in my right thumb and forefinger. I'm almost positive I have gastroparesis, and during periods of my blood sugar being way out of control, I would actually aspirate in my sleep, waking up coughing and choking. This causes difficulty breathing. My heart rate never goes below 100, and 120 is not unusual. I have a thing where my heart will gallop then do some sort of thump-thump thing where it feels like the heart lurches in my chest. My endocrinologist said my thyroid gland is swollen, but my tests came back normal. I've vomited three times in the last week for no apparent reason, with no preceding nausea, just an immediate need to throw up.
Dr. Chelimsky: Yes, you may have a subacute diabetic autonomic
neuropathy, that would account for many of your symptoms. These neuropathies
classically come on early in the course of diabetes, and have a good prognosis,
with recovery expected in 1-2 years. The exact cause is unknown, but may
not be directly due to high sugars. Rather, some type of inflammation of
the autonomic nerves may be playing a role. Have you had any unexplained
weight loss? You would probably need autonomic testing to show the neuropathy
and its severity. Some of these neuropathies, early on, can respond to steroids
or IVIg. If one uses steroids, of course, the sugars have to be monitored
carefully, and sugar control adjusted accordingly. May the Lord bless you
and heal you.
If you have a question, please submit it to Dr. Chelimsky.