Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Nov 15, 2023; 14(11): 1710-1716
Published online Nov 15, 2023. doi: 10.4239/wjd.v14.i11.1710
Rapid correction of hyperglycemia: A necessity but at what price? A brief report of a patient living with type 1 diabetes
Priscille Huret, Philippe Lopes, Randa Dardari, Alfred Penfornis, Claire Thomas, Dured Dardari
Priscille Huret, Philippe Lopes, Claire Thomas, Dured Dardari, LBEPS, University Evry, IRBA, Université Paris Saclay, Evry 91000, France
Randa Dardari, Diabetology, Al Fourkan, Aleppo 90000, Syria
Alfred Penfornis, Dured Dardari, Diabetology, Centre Hospitalier Sud Francilien, Corbeil Essonne 91100, France
Author contributions: Dardari D and Huret P conceived paper; Huret P developed the theory and performed the computations; Huret P, Lopes P, and Thomas C verified the analytical methods; Dardari D encouraged Huret P to investigate supervised the findings of this work; and all authors discussed the results and contributed to the final manuscript.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dured Dardari, MD, PhD, Senior Editor, Diabetology, Centre Hospitalier Sud Francilien, 40 Avenue Serge Dassault, Corbeil Essonne 91100, France.dured.dardari@chsf.fr
Received: July 9, 2023
Peer-review started: July 9, 2023
First decision: August 10, 2023
Revised: August 31, 2023
Accepted: October 16, 2023
Article in press: October 16, 2023
Published online: November 15, 2023
Processing time: 127 Days and 10.3 Hours
Abstract
BACKGROUND

The correction and control of chronic hyperglycemia are the management goals of patients living with diabetes. Chronic hyperglycemia is the main factor inducing diabetes-related complications. However, in certain situations, the rapid and intense correction of chronic hyperglycemia can paradoxically favor the onset of microvascular complications.

CASE SUMMARY

In this case report, we describe the case of a 25-year-old woman living with type 1 diabetes since the age of 9 years. Her diabetes was chronic and unstable but without complications. During an unplanned pregnancy, her diabetes was intensely managed with the rapid correction of her hyperglycemia. However, over the following 2 years, she developed numerous degenerative microvascular complications: Charcot neuroarthropathy with multiple joint involvement, severe proliferative diabetic retinopathy, gastroparesis, bladder voiding disorders, and end-stage renal failure requiring hemodialysis.

CONCLUSION

In the literature to date, the occurrence of multiple microvascular complications following the rapid correction of chronic hyperglycemia has been rarely described in the same individual.

Keywords: Unstable diabetes, Chronic hyperglycemia, Microvascular complication, Type 1 diabetes, Case report

Core Tip: Our case describes a sad and rare development of multiple microvascular complications: Charcot neuroarthropathy with multiple joint involvement, severe proliferative diabetic retinopathy, gastroparesis, bladder voiding disorders, and end-stage renal failure. These devastating complications, which were probably due to the rapid correction of long-term hyperglycemia, severely impacted the quality of life of a young patient with type 1 diabetes.