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Title: Nosocomial treatment-induced neuropathy of diabetes : an important cause of painful and autonomic neuropathy in hospitalized diabetes mellitus patients
Authors: Koh, Jasmine Shimin
Tung, James Wei Min
Lee, Benjamin Jun Hwee
Wong, Xin Yi
Soh, Randy Jing Hang
Thirugnanam, Umapathi N.
Keywords: Science::Medicine
Issue Date: 2019
Source: Koh, J. S., Tung, J. W. M., Lee, B. J. H., Wong, X. Y., Soh, R. J. H. & Thirugnanam, U. N. (2019). Nosocomial treatment-induced neuropathy of diabetes : an important cause of painful and autonomic neuropathy in hospitalized diabetes mellitus patients. Neurology Asia, 24(4), 303-308.
Journal: Neurology Asia
Abstract: Treatment-induced neuropathy of diabetes (TIND) is an acute painful autonomic small-fiber neuropathy that develops following an abrupt improvement in glycaemia control. Recent reports suggest TIND is a significant problem in tertiary neuropathy clinics. TIND in hospitalized patients with poor initial glycaemia control, that we refer to as nosocomial TIND, has not been well-studied. We describe the demographic, clinical features and indices of glycaemia control in 5 consecutive nosocomial TIND patients. TIND was defined using recently published criteria. Pre-meal capillary blood glucose recordings performed during the period of HbA1c decline was used to calculate glycaemic variability. All the nosocomial TIND patients were hospitalized for prolonged periods for serious medical conditions that warranted good glycaemia control, namely severe sepsis, diabetic ketoacidosis, stroke, heart failure and traumatic head injury. They had raised, double-digit, HbA1c levels at admission that subsequently dropped precipitously with tight in-patient glycaemia control protocols. These patients had multiple, largely asymptomatic, hypoglycaemic episodes. Glycaemic variability also appeared to be high in this cohort. TIND may be a significant cause of morbidity in hospitalized diabetic patients with poor glycaemia control. Not all patients developed both autonomic and painful neuropathies, raising the possibility of forme-fruste TIND.
ISSN: 1823-6138
Rights: © 2019 The Author(s) (published by ASEAN Neurological Association). This is an open-access article distributed under the terms of the Creative Commons Attribution License.
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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