@article{rojas2014peripheral,
  title = {Peripheral and Autonomic Neuropathy in an Adolescent with Type 1 Diabetes Mellitus: Evidence of Symptom Reversibility after Successful Correction of Hyperglycemia},
  author = {Joselyn Rojas and Mervin Chávez-Castillo and Wheeler Torres and Carmen Chávez and  Vanessa Apruzzese and Mayela Cabrera and Valmore Bermúdez},
  year = 2014,
  url = {https://ibimapublishing.com/articles/DIAB/2014/899900/},
  journal = {Journal of Research in Diabetes},
  volume = 2014 (2014),
  pages = 22,
  doi = 10.5171/2014.899900,
  abstract = {Introduction: Diabetic neuropathy is the most frequent chronic complication of Diabetes Mellitus (DM), currently considered an irreversible end-organ damage complication. The present case concerns a teenage patient, who after effective glycemic control, was shown to regain sensitive and autonomic nerve function. Case Report: An 18-year-old female patient with Type 1 DM with 6 years of evolution since diagnosis and poor metabolic control (HbA1c 13%) presents to our outpatient clinic with severe sock-pattern burning pain sensation in both lower limbs, which is perceived to have worsened in the previous 6 months despite receiving gabapentin and pregabalin, prescribed in another health center. At physical examination, orthostatic hypotension was evidenced after a fast transition to standing position, tachycardia, muscular hypotrophy of both quadriceps and sural triceps, with a negative Rydel-Seiffert test and a positive Romberg test. Patellar and calcaneal osteotendinous hyporreflexia were found, while hyperalgesia and allodynia to palpation of both feet were present. The RINES-VALCARDI test yielded 8 points at first consultation. She was given patient education concerning her disease and started a strict diet as well as an appropriate insulin therapy to achieve metabolic control. She was treated with duloxetine and capsaicin cream, treatments which she abandoned 6 months later with no observable or measurable relapse of her nerve dysfunctional symptoms; not even one year afterwards. Discussion: This case is unique due to several aspects: The severity of hyperalgesia, and the reversibility of both peripheral and autonomic symptoms after glycemic control and patient education. These elements are fundamental pertaining to reversion of nerve damage.},
  keywords = {Diabetes mellitus, diabetic neuropathy, peripheral diabetic neuropathy, autonomic diabetic neuropathy.},
  note = Article ID: 899900
}