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Diabetic Lumbosacral Plexopathy Treatment & Management

  • Author: Divakara Kedlaya, MBBS; Chief Editor: Robert H Meier, III, MD  more...
 
Updated: Oct 20, 2015
 

Approach Considerations

Most patients are able to avoid inpatient care for diabetic lumbosacral plexopathy. Good glycemic control through the adjustment of diabetes medication (eg, oral agents, insulin) is of paramount importance. Education on proper diet and exercise is also essential. However, because of the sudden onset of functional loss, some patients with the condition may need to be transferred to a subacute rehabilitation facility or a convalescent home for several months, until they recover strength.

A literature review by Kazamel and Dyck suggested that in evaluating patients with diabetes, clinicians should be aware that different types of diabetic neuropathy produce different patterns of abnormal sensation and arise from different pathophysiologic mechanisms.[29]

Go to Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Neuropathy; and Electrophysiology for more information on these topics.

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Surgical Intervention

No surgical intervention is needed for diabetic lumbosacral plexopathy.

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Consultations

Consider consultation with an endocrinologist (eg, with a diabetologist) to assist with the management of diabetes mellitus.

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Physical Therapy

Neurologic recovery is slow for patients with diabetic lumbosacral plexopathy. A physical therapist (PT) can assist in improving a patient's functional mobility (eg, transfers, ambulation). The PT instructs the patient in the use of assistive devices when necessary. An exercise and range-of-motion program supervised by the PT is also helpful to maintain and improve function and avoid contractures.

These patients may derive further benefit from a course of outpatient physical therapy, achieving their maximum potential in terms of functional mobility and lower extremity strength.

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Occupational Therapy

The occupational therapist can recommend appropriate adaptive equipment (eg, a reacher, an elevated toilet seat, a tub bench) based on the degree of weakness the patient is experiencing, so that the patient can be independent in activities of daily living and perform self-care tasks in a seated position.

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Contributor Information and Disclosures
Author

Divakara Kedlaya, MBBS Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Loma Linda University School of Medicine; Medical Director, Physical Medicine and Rehabilitation and Pain Management, St Mary Corwin Medical Center

Divakara Kedlaya, MBBS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Colorado Medical Society, American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Aishwarya Patil, MD Physiatrist (Rehabilitation Physician), Vice Chair, Immanuel Rehabilitation Center

Aishwarya Patil, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, Association of Physicians of India

Disclosure: Nothing to disclose.

Chief Editor

Robert H Meier, III, MD Director, Amputee Services of America; Active Medical Staff, Presbyterian/St Luke’s Hospital, Spalding Rehabilitation Hospital, Select Specialty Hospital; Consulting Staff, Kindred Hospital

Robert H Meier, III, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists

Disclosure: Nothing to disclose.

Additional Contributors

Teresa L Massagli, MD Professor of Rehabilitation Medicine, Adjunct Professor of Pediatrics, University of Washington School of Medicine

Teresa L Massagli, MD is a member of the following medical societies: Academy of Spinal Cord Injury Professionals, American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists

Disclosure: Nothing to disclose.

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