Diabetic Lumbosacral Plexopathy Treatment & Management
- Author: Divakara Kedlaya, MBBS; Chief Editor: Robert H Meier, III, MD more...
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.
No surgical intervention is needed for diabetic lumbosacral plexopathy.
Consider consultation with an endocrinologist (eg, with a diabetologist) to assist with the management of diabetes mellitus.
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.
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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