Objective Evidence for the Reversibility of Nerve Injury in Diabetic Neuropathic Cachexia
- Jaspreet Grewal, MD1,
- Vera Bril, MD1,
- Gary F. Lewis, MD2 and
- Bruce A. Perkins, MD, MPH2
- 1Division of Neurology, Department of Medicine, University of Toronto, Toronto, Canada
- 2Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Canada
- Address correspondence to Bruce A. Perkins, MD, MPH, FRCP(C), Endocrinology and Metabolism, Assistant Professor, University of Toronto, Staff Physician, University Health Network, Toronto General Hospital, 200 Elizabeth St., Room EN-12-217, Toronto, Ontario, Canada M5G 2C4. E-mail: bruce.perkins{at}uhn.on.ca
Diabetic neuropathic cachexia is an acute complication of diabetes marked by such extreme pain and weight loss that, although exceptionally rare, it imparts major challenges in management and diagnosis. Little is known of the fundamental pathophysiologic features of the peripheral nervous system in this condition; for example, the symptomatic resolution that is classically observed may arise from either complete destruction of pain-transmitting nerve fibers or from their repair. To reconcile this issue, we report the first case to our knowledge that the nerve dysfunction is reversible. A 36-year-old woman presented with subacute hyperglycemic symptoms. Soon after initiation of insulin therapy …
