Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Mar 15, 2024; 15(3): 311-317
Published online Mar 15, 2024. doi: 10.4239/wjd.v15.i3.311
Acute worsening of microvascular complications of diabetes mellitus during rapid glycemic control: The pathobiology and therapeutic implications
Dania Blaibel, Cornelius James Fernandez, Joseph M Pappachan
Dania Blaibel, Joseph M Pappachan, Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
Cornelius James Fernandez, Department of Endocrinology and Metabolism, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, Boston PE21 9QS, United Kingdom
Joseph M Pappachan, Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, United Kingdom
Joseph M Pappachan, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
Author contributions: Blaibel D and Fernandez CJ substantially contributed to the initial drafting of the work by performing the literature search, interpretation of relevant literature, with some broad guidance from Pappachan JM and made revisions and figure preparation for the manuscript; Pappachan JM conceptualised the idea, supervised the whole drafting, and revision of the article critically for important intellectual content; all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: Prof. Joseph M Pappachan and colleagues have nothing to declare.
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: Joseph M Pappachan, FRCP, MD, Academic Editor, Consultant Physician-Scientist, Professor, Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Sharoe Green Lane, Preston PR2 9HT, United Kingdom. drpappachan@yahoo.co.in
Received: November 11, 2023
Peer-review started: November 11, 2023
First decision: January 12, 2024
Revised: January 14, 2024
Accepted: February 19, 2024
Article in press: February 19, 2024
Published online: March 15, 2024
Processing time: 124 Days and 23.9 Hours
Core Tip

Core Tip: New onset, or acute worsening of preexisting microvascular complications of diabetes mellitus (DM), is an uncommon complication of rapid improvement of chronic hyperglycaemia from intensive management of DM. Worsening of diabetic retinopathy and treatment induced neuropathy of diabetes are the two common microvascular diseases complicating intensive DM treatment with a rapid glycated haemoglobin reduction more than 2% points within a period of 3 months, though less commonly other complications such as Charcot’s neuroarthropathy, diabetic nephropathy, gastroparesis and urinary bladder dysfunction are also encountered. This editorial discusses the case of a young female type 1 diabetic, intensively managed during pregnancy, developing all these complications, published as a case report in the World Journal of Diabetes, with an appraisal of the current evidence on this uncommon phenomenon.