Acute painful neuropathy induced by rapid correction of serum glucose levels in diabetic patients.
We report on acute painful neuropathy following reduction of high serum glucose levels in six diabetic patients, aged 27-52 (5 males). Initial glucose levels ranging between 270 and 600 mg/dL decreased to 60-160 mg/dL following insulin, pharmacologic or dietary treatment. Four patients had long-standing untreated diabetes (3-5 years). All six patients experienced severe excruciating neuropathic pain 2-4 weeks after initiation of treatment. Pain was generalized in all, starting in the feet in 4 cases. Pain intensity prompted the use of combination therapy with various anti-neuropathic pain agents. Symptoms gradually improved in all patients, allowing discontinuation of symptomatic therapy within 3-8 months. We conclude that acute painful neuropathy can complicate the correction of high glucose levels in diabetic patients. Therefore, careful correction of glucose levels should be considered in patients with long-standing uncontrolled diabetes.
Dabby
Ron
R
Department of Neurology, Wolfson Medical Center, 62 Halochamim Street, Holon 58100, Israel. dabbyr@netvision.net.il
Sadeh
Menachem
M
Lampl
Yair
Y
Gilad
Ronit
R
Watemberg
Nathan
N
D000208:Acute Disease; D000328:Adult; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000178:diet therapy / Q000188:drug therapy; D003929:Diabetic Neuropathies / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin