Thursday, May 3, 2012

tingling feet, shiny tongue,diabetes and Bell telephone

 *Diabetic peripheral sensory neuropathy is the most common complication of Type 1 and Type 2 
 *The early symptoms of diabetic peripheral sensory  neuropathy and B12 deficiency are similar.
 * Metformin ( Glucophage ) is the most commonly used medicine for treating Type 2 Diabetes 
    (see yesterdays post,  metformin  may interfere with the absorption of Vitamin B12) 
 * Don't  overlook B12 deficiency as a cause or contributor to your symptoms.

Symptoms of B12 deficiency
The symptoms of B12 deficiency are vague and non specific.
        Feelings of fatigue , tiredness ,poor memory  are common.

The symptoms of neurological dysfunction are similar to the neurological symptoms associated with diabetes
       Bilateral numbness and tingling in a persons legs and arms, usually more noticeable in the  lower legs
       Clumsiness and lack of coordination can occur. If left untreated the symptoms can progress to more
       severe weakness .

Another physical finding can be a shiny smooth tongue .
Heart murmurs may be found in the patients with anemia.

Answer to yesterdays question:
   Which vitamin can mask some of the laboratory finding of Vitamin B 12 deficiency  ?
 Folic Acid
 Anemia ( megaloblastic anemia ) is one of the classical findings of B12 deficiency. This is characterized by a decreased number  and larger size of red blood cells due to faulty DNA synthesis in the red blood cells. Folic acid will correct this problem and essentially hide this clue of B12 deficiency. Vitamin B12 and/or folic acid is needed for red blood cell development.

History note. 
      Alexander Graham  Bell invented the telephone. He also had diabetes and died from pernicious 

Treatment of B-12  deficiency tomorrow.

Have fun and out smart diabetes
David Calder, MD


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Your comments and questions are appreciated. David Calder,MD