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Treatment-induced neuropathy of diabetes related to abrupt glycemic control

Author/s: 
Stainforth-Dubois, M., Mcdonald, E. G.
Date Added: 
July 20, 2021
Type: 
Meta-analyses, Reviews, and Guidelines
DOI (1): 
10.1503/cmaj.202091
MeSH 
female
glycated hemoglobin a
diabetes mellitus, type 1
insulin
Gastroparesis
hypotension
Nutritionists
Glycemic control
Autonomic nervous system diseases
blood glucose
neuropathy, painful
Peripheral nervous system diseases
pain
Retinal diseases
Humans

RPR Commentary

Aggressive management of blood glucose levels can sometimes precipitate painful peripheral neuropathy, which is usually temporary but may require treatment.

Abstract

KEY POINTS
Rapid correction of glycemic control (i.e., > 2 percentage points of hemoglobin A1c) over 3 months may lead to treatment-induced neuropathy of diabetes.

Symptoms include painful neuropathy, autonomic dysfunction, gastroparesis, early worsening of retinopathy and microalbuminuria.

Women and people with type 1 diabetes are at elevated risk of treatment-induced neuropathy of diabetes.

Management of the condition may include involvement of a dietitian, adjustment of insulin dose and use of medications to improve symptoms such as painful neuropathy, postural hypotension and gastroparesis.