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What Causes Pain In Skin On Touching When Suffering From Diabetes?
Question: hi!
my father is a diabetic patient. he was diagnosed to be diabetic around 4 months ago and now his diabetes is under control... but since he became diabetic he is experiencing a new problem .earlier whenever he touched his skin he used to feel a shivering kind of sensation but now a days he is experiencing pain in the skin on touching.... we went to many doctors,but none of them was able to give a satisfactory explanation...please suggest what to do? also since 5-6 days he was experiencing kind of urine retention ,but had no other symptoms like frequent urination or pain in abdomen etc..we went to a urologist and he suggested an ultrasoud..the reports came normal except a "small cortical cyst in mid pole of right kidney" so i wanted to know is it normal or there is any major issue ?? thanks....
my father is a diabetic patient. he was diagnosed to be diabetic around 4 months ago and now his diabetes is under control... but since he became diabetic he is experiencing a new problem .earlier whenever he touched his skin he used to feel a shivering kind of sensation but now a days he is experiencing pain in the skin on touching.... we went to many doctors,but none of them was able to give a satisfactory explanation...please suggest what to do? also since 5-6 days he was experiencing kind of urine retention ,but had no other symptoms like frequent urination or pain in abdomen etc..we went to a urologist and he suggested an ultrasoud..the reports came normal except a "small cortical cyst in mid pole of right kidney" so i wanted to know is it normal or there is any major issue ?? thanks....
Brief Answer:
This is paresthesia seen in diabetic neuropathy
Detailed Answer:
Hi XXXX
I had gone through your question and understand your concerns.
Your father is probably suffering from diabetic neuropathy. Initial stages of diabetic neuropathy will have pain in the distribution of nerves. Initially it is seen as tingling sensation, later pain on touch (Paresthesia). This is due to diabetes having directly damaging the nerves or the blood vessel supplying a nerve.
The solution for this problems are
1. Improve the diabetic control - His fasting sugars should be less than 130 mg/dl, PPBS less than 180 mg/dl and HbA1c less than 7%. Since he is on a good dose of oral medications, if sugars are not within target, it is better to start him on insulin - at least once daily. The decision can be made after consulting you doctor
2. Improve nutrition - vitamin B complex supplementation, methylcobalamine and vitamin D will improve neuropathy
3. For main neurological medications like Pregabalin, Gabapentin and Amitryptylline can be tried after consulting your doctor. These medications has to be monitored as they can have sedation
Regarding your other concerns:
The renal small cortical cyst just need to be followed up. No treatment needed at present. Usually it wont cause any problem.
Urinary retention can be due to prostatic hypertrophy in this age or it can be due to diabetic cystopathy. This is due to decreased emptying of urine seen in diabetics, that can result in urinary infection and retention. Improving the diabetic will help this.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
This is paresthesia seen in diabetic neuropathy
Detailed Answer:
Hi XXXX
I had gone through your question and understand your concerns.
Your father is probably suffering from diabetic neuropathy. Initial stages of diabetic neuropathy will have pain in the distribution of nerves. Initially it is seen as tingling sensation, later pain on touch (Paresthesia). This is due to diabetes having directly damaging the nerves or the blood vessel supplying a nerve.
The solution for this problems are
1. Improve the diabetic control - His fasting sugars should be less than 130 mg/dl, PPBS less than 180 mg/dl and HbA1c less than 7%. Since he is on a good dose of oral medications, if sugars are not within target, it is better to start him on insulin - at least once daily. The decision can be made after consulting you doctor
2. Improve nutrition - vitamin B complex supplementation, methylcobalamine and vitamin D will improve neuropathy
3. For main neurological medications like Pregabalin, Gabapentin and Amitryptylline can be tried after consulting your doctor. These medications has to be monitored as they can have sedation
Regarding your other concerns:
The renal small cortical cyst just need to be followed up. No treatment needed at present. Usually it wont cause any problem.
Urinary retention can be due to prostatic hypertrophy in this age or it can be due to diabetic cystopathy. This is due to decreased emptying of urine seen in diabetics, that can result in urinary infection and retention. Improving the diabetic will help this.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
sir,
his fasting sugar level is 104 mg/dl, PPBS level is 141 mg/dl and Hba1c is 5.3%...(as per yesterday's reports)....
also sir, can the symptoms of diabetic neuropathy subside with due course of time without the use of medications(as mentioned by you i.e,Pregabalin, Gabapentin and Amitryptylline) as my father has a bad history with medicines...medicines like ornof, levofloxacin etc. has turned out into serious reactions in the past
his fasting sugar level is 104 mg/dl, PPBS level is 141 mg/dl and Hba1c is 5.3%...(as per yesterday's reports)....
also sir, can the symptoms of diabetic neuropathy subside with due course of time without the use of medications(as mentioned by you i.e,Pregabalin, Gabapentin and Amitryptylline) as my father has a bad history with medicines...medicines like ornof, levofloxacin etc. has turned out into serious reactions in the past
Brief Answer:
Try with other agents
Detailed Answer:
Hi XXXX
I have gone through the reports.
I can understand your concern on medications.
We can try medications without side effects live vitamin supplementation. The pain can also relieved by skin creams like Capsaicin cream which is used for patients with painful neuropathy who cannot tolerate medications.
The diabetic control is excellent. No need of insulin at this point.
Regards
Dr Ajish TP
Consultant Endocrinologist
Try with other agents
Detailed Answer:
Hi XXXX
I have gone through the reports.
I can understand your concern on medications.
We can try medications without side effects live vitamin supplementation. The pain can also relieved by skin creams like Capsaicin cream which is used for patients with painful neuropathy who cannot tolerate medications.
The diabetic control is excellent. No need of insulin at this point.
Regards
Dr Ajish TP
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
thanks a lot sir,i did bring a cream containing capsaicin 2 weeks ago and he is using it,but no significant relief.....however sir, i wanted to know will the cyst in the renal cortex be a matter of concern in future...i know the cysts of renal cortex are of benign type,but can it grow or rupture in future or increase in number and will it be a major issue? thanx..
Brief Answer:
Usually asymptomatic and no treatment needed
Detailed Answer:
Hi XXXX
Nice to hear from you again.
There wont be always instant relief in neuropathy. Keep using the medications for some more time.
Simple renal cyst are just collection of fluid in kidney. They wont usually enlarge or rupture or cause decrease in kidney function. So no need to worry and no treatment is needed. Very rarely they can cause obstruction urine flow or blood flow in kidneys. In those situation it need to be removed.
This is a very rare situation - so not a major issue - No need to worry now.
Regards
Dr Ajish TP
Consultant Endocrinologist
Usually asymptomatic and no treatment needed
Detailed Answer:
Hi XXXX
Nice to hear from you again.
There wont be always instant relief in neuropathy. Keep using the medications for some more time.
Simple renal cyst are just collection of fluid in kidney. They wont usually enlarge or rupture or cause decrease in kidney function. So no need to worry and no treatment is needed. Very rarely they can cause obstruction urine flow or blood flow in kidneys. In those situation it need to be removed.
This is a very rare situation - so not a major issue - No need to worry now.
Regards
Dr Ajish TP
Consultant Endocrinologist
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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