Hyperglycaemia-induced diabetic amyotrophy: a case report from a family medicine clinic

Type two diabetes mellitus (T2DM) is a common health problem in primary care. Hyperglycaemia is a manifestation of T2DM and causes several complications. Diabetic neuropathies are a common complication and have been found in several forms and presentations.1 This article reports on a patient with T2DM, who presented in primary care with progressive lower extremity weakness and walking difficulty. A 64-year-old male visited a family medicine clinic due to lower extremity weakness lasting 1 month. The patient could not walk without assistance or walking aids. He was fully conscious and presented at the clinic in a wheelchair. He had numbness and a tingling sensation in his feet. There had been a 7 kg weight loss (from 60 to 53 kg) in a month. The patient had a past medical history of T2DM, diagnosed approximately 10 years previously. His medications were metformin 1000 mg daily and glipizide 10 mg daily; though he had irregularly attended his diabetes clinics, his adherence to medications was variable and he had had no recent follow-up or blood tests. His vital signs were blood pressure, 141/93 mmHg; pulse, 108 beats per minute; respiratory rate, 20 breaths per minute; and temperature, 36.5°C. Physical examination of the nervous system revealed a decrease in motor power related to both hip flexion and elbow extension (grade …