Top Document: diabetes FAQ: treatment (part 3 of 5) Previous Document: Alcohol and Diabetes Next Document: Has anybody heard of frozen shoulder (adhesive capsulitis)? See reader questions & answers on this topic! - Help others by sharing your knowledge Necrobiosis lipoidica diabeticorum (NLD) consists of oval plaques, usually on the lower legs. It may start as small red spots or raised areas, which develop a shiny, porcelain-like appearance. The plaques often turn a light color due to extracellular fat (the "lipoidica"). They are often itchy or painful. Typically the spots turn a brownish color, which fades slowly but is permanent. NLD is not related to any other complication of diabetes. In particular, NLD does not presage eye, kidney or vascular problems. NLD is much more common in diabetics, who account for perhaps 2/3 of all cases. Many of the remainder develop diabetes, and NLD should be considered a warning sign of diabetes. Reports vary widely on exactly who is most at risk. About 1% of diabetics have some degree of NLD ... plus or minus 1%, depending on which report you read. Some reports say NLD occurs more often in young women, but some textbooks disagree. The real dangers seem to be ulceration, infection, and the stress from the appearance. Ulceration sometimes occurs spontaneously, and often as a result of trauma. Ulceration is often a result of scratching or trauma, and the ulceration from scratching sometimes heals very slowly. Thus avoiding scratching and trauma decreases the amount of ulceration, though some ulceration will occur anyway. There are some images of NDL lesions at http://tray.dermatology.uiowa.edu/DermImag.htm No particularly good treatment seems to be known. Topical steroids (that is, creams) are the most common first choice. The ulcerations usually heal if cared for properly, and drastic measures are not called for in most cases. William Biggs reports that skin grafts may be necessary in cases of severe ulceration, but do not tend to give results that are cosmetically attractive. Other treatments reported to help sometimes are oral aspirin, pentoxifylline, dipyridamole, locally injected steroids, and systemic steroids. No one claims to be able to predict what will work on any given patient, and often not much of anything is effective. However, the ulcers usually heal if given supportive treatment. Surgery should be avoided. Ineke van der Pol reports finding relief in Chinese herbal treatments. STEROID WARNING: locally injected and systemic steroids raise blood glucose and cause severe problems regulating blood glucose. These should be used only as a last resort. Topical steroids (creams and inhalers) cause no such problems. Note that treatment is not a medical necessity except for ulcerations and infections. Otherwise, the purpose of treatment is to prevent ulcerations and infections, decrease pain and itching, and improve the appearance. NLD is the subject of occasional articles in scientific journals on diabetes and on dermatology. Betsy Butler has researched the medical journals, finding little beyond what I've reported above -- in her words, "no good answers". _Therapy for Diabetes Mellitus and Related Disorders_, published by the ADA, has a section on necrobiosis lipoidica diabeticorum and its treatment. Ineke van der Pol has started a mailing list about NLD at http://groups.yahoo.com/group/necrobiosis. I thank the following people, especially Betsy, who posted the information from which I derived this section: Betsy Butler Polley (who says sorry, she doesn't have any information besides what's here) William Biggs <reddy_biggs(AT)msn.com> Tari M. Birch <tm_birch(AT)pnl.gov> Terence Griffin (who also says he doesn't have any other info) Bill Barner <barner(AT)mail.loc.gov> Ineke van der Pol <fluo(AT)chello.nl> (who has no further information but is happy to correspond about NLD if you wish) User Contributions:Comment about this article, ask questions, or add new information about this topic:Top Document: diabetes FAQ: treatment (part 3 of 5) Previous Document: Alcohol and Diabetes Next Document: Has anybody heard of frozen shoulder (adhesive capsulitis)? Part1 - Part2 - Part3 - Part4 - Part5 - Single Page [ Usenet FAQs | Web FAQs | Documents | RFC Index ] Send corrections/additions to the FAQ Maintainer: edward@paleo.org
Last Update March 27 2014 @ 02:11 PM
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between and mg/dl and mmol/l is, i came across your article and was so pleased to aquire a lot more info regarding blood glucose, how to read and convert it.