Clinical Pain

Korean Association of Pain Medicine (대한임상통증학회)
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Treatment-Induced Neuropathy of Diabetes

타입 1형 당뇨 환자에서 급작스런 혈당조절에 의해 발생한 신경염

  • Kim, Kee Hoon (Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital) ;
  • Leem, Min Jeong (Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital) ;
  • Yi, Tae Im (Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital) ;
  • Kim, Joo Sup (Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital) ;
  • Yoon, Seo Yeon (Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital)
  • 김기훈 (분당제생병원 재활의학과) ;
  • 임민정 (분당제생병원 재활의학과) ;
  • 이태임 (분당제생병원 재활의학과) ;
  • 김주섭 (분당제생병원 재활의학과) ;
  • 윤서연 (분당제생병원 재활의학과)
  • Received : 2019.07.18
  • Accepted : 2019.10.08
  • Published : 2020.06.30
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Abstract

Treatment-induced neuropathy in diabetes (TIND) is a reversible neuropathy that occurs in patients with diabetes, usually after a fast improvement in glycemic control. TIND is defined as the sudden onset of neuropathic pain or autonomic dysfunction with a large improvement in glycemic control (glycated hemoglobin [HbA1c] level of ≥ 2% over 3 months). We report the first case of a 24-year-old woman with type 1 diabetes mellitus who developed TIND in Korea. Her HbA1c level had decreased from 16.7% to 7.3% within a 3-month period. She developed acute-onset, severe, and continuous burning pain affecting her back and lower extremities. She was administered tapentadol (50 mg), pregabalin (75 mg), and vitamin B with minerals twice daily for neuropathic pain. She complained of orthostatic hypotension; thus, midodrine (2.5 mg) and anti-embolic stockings were prescribed. She almost completely recovered 6 months after the onset. A physician should be aware of TIND and gradually reduce HbA1c levels to prevent the occurrence of TIDN. They must also try to provide relief from severe pain or autonomic dysfunction and emphasize on an almost complete recovery.

Keywords

References

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