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Swelling And Severe Pain In Feet. Taking Medicine For Diabetes. Surgery Needed?

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Posted on Wed, 9 Jan 2013
Question: I was not knowing for how long I was suffering from diabetics but when I came to know about it , it was 350 for fasting . Now after one year when I am 40 yrs old, I am feeling severe pain in my feet , thigh and groin area, making my life hell . I am always feeling restless and not getting respite even though I have controlled my sugar level to the extend of 130 (fasting). When visited local doctor , I got that the pain and inflammation in feet and groin area is due to neuropathy and my nerves are damaged due to excessive glucose in blood. I have taken medicine like pragabalin and other injection courses of Vitamin B6, B12 ( Renerve and others ) but got relief only for hours or two after medication. My queries are :(1) Are nerve damaged can be regenerated; if yes than how long it may take and what precaution and medication have to go through. (2) If the damage is severe than is it curable and is any type of surgery is required.
Kindly enlighten me about it and make my life painless.
doctor
Answered by Dr. Madhuri Patil (1 hour later)
Hi XXXXXXX

Thank you for the query.

1. The nerve damage due to diabetic neuropathy when diabetes is diagnosed newly can be controlled fully. Cure happens if you control the sugars perfectly for years from now on as your diabetes is newly diagnosed. So keep hopes. You must continue taking tablet pregabalin or gabapentin everyday as those are safe medications.
So the only precaution is keep sugars under perfect control and eat balanced food for optimum minerals and vitamins in the body.
In your case, because diabetes is newly diagnosed, I can say taking 95 % chance that you do not have nerve damage yet but something called hyperglycemic irritation of your nerves. If sugars continue to remain high, it turns into damage further. But at this stage your months to years' efforts will stop the neuronal irritation for sure.
2. If the symptoms remain unchanged in spite of sugar control, taking pregabalin or gabapentin then you must see a neurologist for ruling out reasons other than diabetic neuropathy and Vit deficiency neuropathy. Then your course of investigations and treatment may differ as per the Neurologist's advice.
Otherwise, if your symptoms reduce as I explained in first answer then they are due to new onset high sugars only and will disappear after a few months' time.
I hope you got your answer. Please get back to me for any further query. Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Madhuri Patil (19 hours later)
I have been taking pragabalin for more than 6 months and also keeping my sugar level controlled, but then also I am under severe pain for my feets, thighs and groin areas.
Also , I don't know for how long I was having diabetes , so it may be newly diagonised but not early diagonised . What are the other reasons for nearopathy.
I have been taking Pregeb-M 75 , can I go for Pregeb-M 150 for more
relief without any adverse effect. let me know what are the side effects of
taking pregabalin for longer duration. Also guide me about the best neurologist in Orissa.

Regards
doctor
Answered by Dr. Madhuri Patil (4 hours later)
XXXXXXX

Then seeing neurologist is the only way for you as it's been more than 6 months. I agree for the delayed diagnosis of your diabetes, but still we call it newly diagnosed diabetes.
The other reason for you to see a Neurologist might be because even your groin area is involved which shows a bunch of nerves coming out of your spine are getting irritated. This is uncommon in diabetic neuropathy.
Taking pregabalin for long time as such does not have serious side effects and doses can be increased by the patient himself/ herself upto 600 mg/ day. Some people get giddiness or swelling in lower limbs and rarely low sodium level in the body. This is certainly not happening in you. So keep taking that tablet for three times a day till you see a Neurologist.
Other than diabetes the reasons of such neuropathy can be vitamin B 12, B 6 deficiency, Neurtitis (inflammation of the nerves), Neuronal trapping in between your two vertebrae- in this case you also may have numbness in that area, Any small neuronal bulging etc. Your clinical examination by the Neurologist and probably one MRI of the lumber vertebrae will give clear idea on the reason in your case.
In Orissa, I am sorry that I do not have any direct contact with any of the Neurologists. But you can check with good teaching institutes (hospital attached with medical college) where generally very good Neurologists are available.
Any further query, Please get back. Take care and all the best.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Madhuri Patil

Diabetologist

Practicing since :1999

Answered : 362 Questions

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Swelling And Severe Pain In Feet. Taking Medicine For Diabetes. Surgery Needed?

Hi XXXXXXX

Thank you for the query.

1. The nerve damage due to diabetic neuropathy when diabetes is diagnosed newly can be controlled fully. Cure happens if you control the sugars perfectly for years from now on as your diabetes is newly diagnosed. So keep hopes. You must continue taking tablet pregabalin or gabapentin everyday as those are safe medications.
So the only precaution is keep sugars under perfect control and eat balanced food for optimum minerals and vitamins in the body.
In your case, because diabetes is newly diagnosed, I can say taking 95 % chance that you do not have nerve damage yet but something called hyperglycemic irritation of your nerves. If sugars continue to remain high, it turns into damage further. But at this stage your months to years' efforts will stop the neuronal irritation for sure.
2. If the symptoms remain unchanged in spite of sugar control, taking pregabalin or gabapentin then you must see a neurologist for ruling out reasons other than diabetic neuropathy and Vit deficiency neuropathy. Then your course of investigations and treatment may differ as per the Neurologist's advice.
Otherwise, if your symptoms reduce as I explained in first answer then they are due to new onset high sugars only and will disappear after a few months' time.
I hope you got your answer. Please get back to me for any further query. Take care.