Rarely a patient with diabetes may develop unexplained cachexia.


Clinical features:

(1) usually a middle aged to elderly male

(2) type 2 diabetes, often mild and controlled without insulin

(3) anorexia

(4) diabetic peripheral neuropathy, bilateral and symmetrical

(5) severe pain

(6) depression or other emotional disturbance

(7) marked weight loss

(8) impotence

(9) variable constipation

(10) spontaneous recovery after several months (up to 24 months)


Differential diagnosis: other sources of cachexia, especially occult malignancy


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