title: Aggressive and devastating neuropathy: the consequence of untreated slow-onset type 1 diabetes.
abstract: Though type 1 diabetes (T1D) is described to be a disease of acute onset, there is strong evidence for a period of subclinical hyperglycaemia leading up to diagnosis. We describe two clinical cases with a prolonged and insidious onset of T1D, where neurological complications were present at the time of diagnosis. In both, there was an initial rapid and debilitating progression in neurological as well as other microvascular complications, but with a subsequent stabilization in complications over the next few years. These rare and unusual cases illustrate the variable nature of the natural history of T1D as well as its microvascular complications.
authors.affiliation: Department of Diabetes, University Hospital Birmingham NHS Foundation Trust, Birmingham, B15 2TT, UK. p.narendran@bham.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: Narendran
authors.forename: S J
authors.initials: SJ
authors.lastname: Creely
authors.forename: A
authors.initials: A
authors.lastname: Syed
authors.forename: S
authors.initials: S
authors.lastname: Tesfaye
authors.forename: J
authors.initials: J
authors.lastname: Winer
authors.forename: B M
authors.initials: BM
authors.lastname: Singh
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis; D003925:Diabetic Angiopathies / Q000209:etiology; D003929:Diabetic Neuropathies / Q000209:etiology*; D003930:Diabetic Retinopathy / Q000209:etiology; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D008297:Male