Question

How prevent muscle of sholder and neck in diabetes?

Answer 1

Answer:

Diabetic muscle infarction is a rare, but potentially disabling condition. The infarction tends to be spontaneous, without a history of trauma. It affects patients with a long history of poorly controlled diabetes and is most common in diabetic patients who require insulin. Most patients affected with infarctions have multiple micro-vascular complications typical of DM including peripheral neuropathy, nephropathy, and retinopathy. Muscle infarction in this instance is mostly the result of ischemia. It can, however, been seen during episodes of diabetic ketoacidosis, especially while the patient is being treated in the intensive care unit.8

It should also be kept in mind that many patients with DM also have dyslipidemias, either secondary to or in addition to their DM. Therefore, in addition to their DM medication regimen, they may also be taking an HMG-coA reductase inhibitor (statin medication) for lipidemic control. Statins are, unfortunately, rather well known for their ability to cause rhamdomyolysis in some patients.9

The clinical presentation of muscle infarction is that of an acute onset of pain and swelling over days to weeks in the affected muscle groups along with varying degrees of tenderness. The most often affected region is the thigh or calf. Creatine phosphokinase (CPK) levels may be normal or elevated, depending upon the degree of muscular involvement. The muscle isoenyme of CPK, CPK-MM helps to confirm the diagnosis. Other laboratory investigations are done to exclude other muscular conditions, such as tumor, infectious myositis, thrombophlebitis/thrombosis, localized myositis, or osteomyelitis. Muscle biopsy may be needed to confirm the diagnosis. The primary findings on biopsy are muscle edema and necrosis.

Rest and analgesia are the hallmarks of therapeutic management. Normal activities of daily living are not deleterious to the condition, but some physical therapy modalities may cause exacerbation. In most cases, spontaneous diabetic muscle infarction tends to resolve over a period of weeks to months.

Explanation: