Evaluation of patients with diabetes

Bilateral lower limb paraesthesis  is common in diabetic patients but Draman et al. show that peripheral neuropathy in a diabetic could be due to aetiologies other than diabetes.

They present a case of a 28-year-old man with a long history of type 1 diabetes mellitus presented with bilateral paraesthesia of both feet and unsteady gait. Investigation showed he had subacute combined degeneration of the cord.

The patient had rapid symptomatic improvement with i.m. vitamin B12 injection.  Pernicious anaemia is known to be more common in patients with type 1 diabetes. Cobalamin deficiency is reversible if detected early enough and treated by B12 replacement. By contrast, diabetic neuropathy is generally a progressive complication of diabetes.

Read the full details of this case at Draman et al (2013) Endocrinology, Diabetes and Metabolism Case Reports 8; EDM130034; DOI: 10.1530/EDM-13-0034.