Diabetic muscle infarction (DMI) is the muscle tissue damage due to diabetes. It is a medical condition in which tissue dies because its blood supply is cut off. It is a rare complication in patients with advanced diabetes mellitus (DM). Patients having diabetic nephropathy are prone to develop diabetic muscle infarction.
It is caused by infarcted (tissue death due to inadequate blood supply to the affected area) muscle tissue, most commonly in the thigh. Nearly one-fourth of Diabetic muscle infarction patients receive renal replacement treatment.
Because its symptoms can be easy to miss, DMI is often not noticed or treated as quickly as it should be. Anyone who has diabetes should be aware of the possibility of developing DMI. If you suspect that you might have DMI, then you should seek immediate medical attention.
HOW IS THIS MUSCULAR INFARCTION RELATED TO DIABETES?
Diabetic muscular infarction causes sore, painful area in a muscle, usually a thigh muscle. It is called diabetic because it is caused by circulation problems that are the result of long-term diabetes.
DMI sometimes occurs in the calf muscles (19% of all cases). It is most common in people who have lived for years with type 1 diabetes (which typically is childhood diabetes and requires insulin) and who have poor glycemic control; that is, for whatever reason, they have not been able to keep their blood sugar levels under control.
Women are more likely than men to get DMI. Most of the patients with DMI have diabetes-related damage to other organs as well, including kidneys, eyes and nerves.
WHAT CAUSES DMI?
Cause of DMI or how the disease progresses is not completely understood. While arteriosclerosis (hardening of the arteries) and diabetic microangiopathy, (damage to the small blood vessels caused by diabetes) are always present in those with DMI, it is thought that something else sets off the muscle infarction itself.
It is hypothesized that blood vessel blockage produces muscle tissue damage, leading to an inflammatory response and an increase in blood flow to the area. This in turn leads to swelling. As the muscle swells, it increases pressure on the small blood vessels and reduces blood flow further. This cycle causes extensive muscle tissue death.
The thigh muscles may be particularly susceptible to damage because they carry a heavy mechanical load as we walk or carry out other normal daily activities.
HOW DIABETIC MUSCLE INFARCTION GROW INSIDE BODY?
DMI can come and go. It typically begins with muscle pain and swelling. After that, the pain partially falls down and a tender mass appears that can be felt through the skin. Of the muscles in the thigh, the quadriceps is the most commonly affected muscle.
Both thighs are affected in 8% of cases. In a minority of cases, DMI causes fever and skin redness. There is only one known case of DMI in an arm muscle.
Perhaps because people who suffer from DMI often do not understand what it is, there is often a significant lag between the time people first having DMI symptoms and when they seek medical attention. Treated with rest and pain killers, the symptoms gradually go away over time. But DMI recurs in 48% of cases, about 9% involving the originally affected muscle and 39% involving another muscle.
HOW CAN DMI BE DIAGNOSED?
- Standard x-rays are rarely helpful in diagnosing DMI.
- The most valuable diagnostic tool is MRI.
- Ultrasonography has also been recommended as a preferred diagnostic tool.
HOW CAN THIS COMPLICATION BE MANAGED?
The most favored treatment strategies for DMI include:
- Sugar control: Being the primary cause of DMI, it is important to control your blood sugar levels. This can be done by controlling diet (free of carbohydrates) and taking medicines on time. Unscheduled medications and skipping the dose can lead to uncontrolled diabetes.
- Exercise: By consulting an expert, conduct exercises to relieve your pain the legs and to continue the blood circulation which might have blocked due to hardening of blood vessels. Do not perform harsh exercises which could insert load on your legs.
- Conservative management: This includes proper bed rest which will lower the pressure on thighs and legs and consumption of prescribed pain killers for managing muscle pain.
- Surgical therapy
Studies show that DMI sufferers who had either conservative or drug therapy had a significantly shorter recovery time and fewer recurrences of DMI than those who underwent surgery.
Complications from surgery: There are also the usual postoperative complications from surgery, including infection and delayed wound healing.