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Treatment-induced diabetes neuropathy: description of singular clinical signs to reach a prompt diagnosis
  1. Pablo Guisado Vasco1,
  2. ­Marcos Llanero-Luque2,
  3. Marta Cano-Megías3 and
  4. María Cortés-Berdonces4
  1. 1Internal Medicine, Hospital universitario quironsalud Madrid, Madrid, Spain
  2. 2Neurology, Complejo hospitalario Ruber Juan Bravo, Madrid, Spain
  3. 3Endocrinology, Hospital General Universitario de Guadalajara, Guadalajara, Castilla-La Mancha, Spain
  4. 4Endocrinology, Complejo hospitalario Ruber Juan Bravo, Madrid, Spain
  1. Correspondence to Dr Pablo Guisado Vasco; pablogvasco{at}


A 23-year-old woman diagnosed with type 1 diabetes mellitus in 2011 came to our outpatient office because of an inability to walk correctly. She was under a basal bolus insulin regimen. In the summer of 2016, she experienced a rapid improvement in her glycaemic control. A few weeks later, she started to complain of a severe burning pain in the soles of her feet (pain score 10/10). Neither macrovascular nor microvascular complications were detected. The patient was forced to walk barefoot due to an intense pain using shoes or socks and used to soak her feet in water for several hours daily. She also developed severe intolerance to environmental heat, both indoors and outdoors. A diagnosis of treatment-induced diabetic neuropathy was made. The patient was admitted to a general ward to start pain therapy. After a 6-month course of different neuropathic pain drugs, the patient was able to walk autonomously again.

  • diabetes
  • neuroendocrinology
  • pain (neurology)

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  • Contributors MC-M and PGV researched clinical data, wrote and drafted the manuscript. ML-L and MC-B contributed to discussion and reviewed/edited the manuscript. All authors critically reviewed the manuscript for important intellectual content and approved the final version. All authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the article are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.