Pain is most severe in the thighs, back, or both. Diabetic amyotrophy renders the quadriceps muscle group weak almost continuously, while muscles in the buttocks and back of the thighs experience weakness about half the time. A working theory on the cause of amyotrophy states that inflamed blood vessels interrupt and slow blood supply to the nerves. This theory could explain why weakness comes and goes in some muscle groups but is continuous in others.

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