A transient neuropathy may develop in a diabetic following initiation of better glycemic control. This is associated with a temporary decrease in nerve perfusion.


Clinical features:

(1) The acute onset of symmetric pain and dysesthesia in the legs.

(2) The onset follows initiation of glycemic control, typically involving the use of insulin.

(3) The symptoms resolve within weeks or months.


It may be challenging to keep the patient adherent to a regimen that in the patient's mind worsened symptoms.


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