Acute painful diabetic neuropathy precipitated by strict glycaemic control
Abstract
A case of acute painful diabetic neuropathy that followed the establishment of strict glycaemic control using continuous subcutaneous insulin infusion is described. Sural nerve biopsy shortly after the onset of the acute painful syndrome showed no evidence of active nerve fibre degeneration; instead, the appearances were those of a chronic neuropathy with prominent regenerative activity. The suggestion is made that adequate diabetic control promoted regeneration and that the pain may have been related to the ectopic generation of impulses in regenerating axon sprouts.
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Rapid improvement in blood glucose levels may be associated with transient early worsening of retinopathy or the development of acute painful neuropathy.
“The rate of optimizing blood glucose levels in this group of people should also be individualized as rapid improvement may be associated with transient early worsening of retinopathy or the development of acute painful neuropathy (278,279).”
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Vinik, A. I., Maser, R. E., Mitchell, B. D., & Freeman, R. (2003) · Diabetes Care · doi:10.2337/diacare.26.5.1553 · Cited by 2,044 · see citing works
Holt, R. I. G., DeVries, J. H., Hess-Fischl, A., Hirsch, I. B., Kirkman, M. S., Klupa, T., Ludwig, B., Nørgaard, K., Pettus, J., Renard, E., et al. (2021) · Diabetes Care · doi:10.2337/dci21-0043 · Cited by 699 · see citing works
Treatment-induced diabetic neuropathy: A reversible painful autonomic neuropathy
Gibbons, C. H., & Freeman, R. (2010) · Annals of Neurology · doi:10.1002/ana.21952 · Cited by 213 · see citing works
The Spectrum of Diabetic Neuropathies
Tracy, J. A., & Dyck, P. J. B. (2008) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2007.10.010 · Cited by 164 · see citing works
- Authors
- Llewelyn, J. G., Thomas, P. K., Fonseca, V., King, R. H. M., & Dandona, P.
- Affiliations
- The Royal Free Hospital (GB)
- Venue
- Acta Neuropathologica
- Published
- 1986
- Volume
- 72
- Issue
- 2
- Pages
- 157-163
- ISSN
- 0001-6322 (ISSN-L)
- 1432-0533
- OpenAlex
- W2082855867
- Cited by
- 121
- References
- 0
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 6 · 2016: 3 · 2015: 5 · 2014: 4 · 2013: 3 · 2012: 1
- FWCI
- 0.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Acta Neuropathologica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- insulin pump therapy, sural nerve biopsy, nerve regeneration, diabetic neuropathy
- MeSH terms
- Acute Disease, Adolescent, Blood Glucose, Diabetes Mellitus, Type 1, Diabetic Neuropathies, Female, Humans, Insulin Infusion Systems, Nerve Regeneration, Pain, Sural Nerve
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