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Dr.Saleem
Dr.Saleem, Doctor
Category: Medical
Satisfied Customers: 2934
Experience:  MBBS
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I suffer from diabetes also crohnes and have had 2 small heart

Customer Question

I suffer from diabetes also crohnes and have had 2 small heart attacks I now live in Spain my problem is I feel so weak and get tingling in my hands and legs I am thinking of returning to England just to get some help although the Spanish doctors are very good but nothing is helping me
Submitted: 4 years ago.
Category: Medical
Dr.Saleem
Expert:  Dr.Saleem replied 4 years ago.
Hi
Welcome to JA!
Thanks for the question..

The tingling sensation in hands and feet is a symptom of neuropathy (damage to the peripheral nerves) called paresthesia which can be caused by diabetes or deficiency of vitamin B12 in your case (malabsorption due to crohns' disease)

Firstly it is important to consult a physician or neurologist to conduct tests like B12 levels and nerve conduction studies to determine the cause.

Based on cause the treatment will depend on the replacement of b12 in case of its deficiency and in case of diabetic neuropathy, we have following options:
Treatments that may be beneficial for painful diabetic neuropathy include a number of antidepressants (eg, amitriptyline, duloxetine, venlafaxine) and anticonvulsants (eg, pregabalin, sodium valproate) as well as capsaicin cream, lidocaine patch, alpha-lipoic acid, isosorbide dinitrate topical spray, and transcutaneous electrical nerve stimulation.

One of the antidepressants (eg, amitriptyline, duloxetine, venlafaxine) or anticonvulsants (eg, pregabalin) is used as initial therapy for patients with painful diabetic neuropathy. The available limited evidence suggests that these agents have similar modest benefit. Patients who fail to improve with a reasonable trial of one of these agents can be switched to monotherapy with another agent.

For patients who do not improve on one drug, combination therapy employing two drugs from different medication classes is used as the next step in the treatment paradigm. For patients who are unable to tolerate any of these drugs, alternative treatments include capsaicin cream, lidocaine patch, alpha-lipoic acid, isosorbide dinitrate topical spray, and transcutaneous electrical nerve stimulation.

The use of opioids for chronic nonmalignant pain is controversial.

If you have more questions, feel free to ask..
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Customer: replied 4 years ago.
Would I benefit more returning to England for this treatment as in Spain they just keep giving tablets rather than referral
Expert:  Dr.Saleem replied 4 years ago.
Yes if you consult a specialist neurologist that will benefit more either in spain or england.
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Expert:  Dr.Saleem replied 4 years ago.
If you have more questions, plz feel free to ask!
If you are satisfied with the answer, kindly rate 3,4 or 5 to get me paid for my service.

regards
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Expert:  Dr.Saleem replied 4 years ago.
Hi Pauline,


I'm just following up with you to see how everything is going. Did my answer help?


Let me know,
Dr.M.Saleem
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