ABSTRACT
Introduction:
This
case study portrays an unusual case of
treatment-induced neuropathy of diabetes (TIND) in a
patient with uncontrolled
type 2 diabetes (T2D)
who achieved rapid improvement in
glucose control primarily with dietary intervention. Initial presentation was 50-year-old
white male with a long-standing
history of
obesity and a
family history of T2D with a
screening glucose level >500mg/dL by glucometer, HbA1c of 14.9%, and initial weight 213 lbs.
Methods:
The initial intervention included a
low-carbohydrate diet,
metformin, and a continuous
glucose monitor (CGM). Semaglutide was added after seven days.
Results:
His glycemia was within the target range within three weeks. Four weeks after initiation of
therapy, he developed TIND symptoms consisting of burning, tightness, and
numbness of bilateral
feet along with 10/10
pain. At three months, his HbA1c dropped to 6.9% and his weight to 195 lbs.
Treatment of his TIND reduced his
pain from 10/10 to 2/10.
Conclusion:
Whereas TIND is commonly associated with the use of
insulin or sulfonylureas, this study adds evidence to the paucity of
literature regarding TIND precipitated by dietary intervention.
