Diabetes-Related Proximal Lower Limb Muscle Weakness: A Case Report Interpreted Through Medo Avruta Vata

Abstract

Diabetes mellitus is a chronic metabolic disorder associated with multiple microvascular and macrovascular complications; however, involvement of skeletal muscle remains under-recognized. Diabetes-associated muscle dysfunction may present with progressive weakness, pain, and functional impairment, significantly affecting quality of life. This case report describes a young female with long-standing type 2 diabetes mellitus who presented with progressive right lower limb pain, muscle wasting, and weakness predominantly affecting the calf and distal leg muscles. Clinical examination revealed hypotonia, reduced muscle strength, gait abnormality, and preserved deep tendon reflexes, with minimal sensory involvement. Laboratory investigations showed poor glycemic control with elevated glycated hemoglobin levels, while serum creatine phosphokinase levels were within normal limits. Electromyography and nerve conduction studies demonstrated myopathic changes with superficial peroneal nerve involvement. Magnetic resonance imaging of the lower limbs revealed muscle atrophy with fatty infiltration, supporting the diagnosis of diabetes-associated skeletal muscle dysfunction. From an Ayurvedic perspective, the clinical features were correlated with Medo Āvṛta Vāta, occurring in the background of chronic Prameha. The patient was managed using an integrative therapeutic approach comprising Prameha chikitsā and Āvaraṇa-hara Vāta chikitsā, including internal medications and external therapies. Significant improvement was observed in pain intensity, muscle strength, gait, and overall functional capacity over the treatment period. This case emphasizes the importance of early recognition of diabetes-related muscle involvement and highlights the potential role of integrative diagnostic and therapeutic strategies in the holistic management of neuromuscular complications associated with chronic metabolic disorders.