Published online Nov 15, 2023. doi: 10.4239/wjd.v14.i11.1710
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
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.
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.
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.
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.