Painful Diabetic Neuropathy

Early onset of severe diabetes mellitus-related microvascular complications

“…There are reports of a 32-yearold man with newly diagnosed T1DM and an 18-year-old woman with poorly controlled T1DM of 8-year duration, both of whom had severe peripheral neuropathy after rapid improvement of hyperglycemia with insulin therapy. 7,8 In both, as in our patient, the neuropathy lasted several months, with resolution of symptoms despite persistently abnormal nerve conduction studies.…”

Adolescent Diabetic Amyotrophy

“…Campbell et al ( 5 ) demonstrated impaired peripheral and autonomic nerve function in newly diagnosed adult diabetics which partially improved when their diabetes was treated, and this has been interpreted as supporting a direct metabolic effect on nerve fibres. Paradoxically, there are anecdotal reports of diabetic complications including retinopathy and peripheral neuropathy being precipitated apparently by a rapid tightening of diabetic control after starting continuous insulin infusion (6). In the case of retinopathy this has been associated with increased platelet aggregability.…”