Abstract
We report the case of a diabetic patient who developed beriberi after being started on a severer protein-restricted diet and diuretic therapy.
A 54-year-old woman with a 14-year history of slowly progressive type 1 diabetes mellitus was admitted to our hospital because of a progressive sensory disturbance in the extremities, muscle pain and weakness, gait disturbance, and peripheral edema. She had started a low-protein diet (50 g/day ; 0.8 g/kg ideal body weight) at age 51. Three months previously, she had been admitted to the nephrology department of our hospital for amoxicillin-induced acute renal failure, and at that time, her protein intake had been further restricted to 30 g/day and furosemide had been started.
Cardiomegaly (C/T ratio ; 53.9%) and a heart murmur were observed in addition to neurological abnormalities, and a subsequent blood examination revealed vitamin B1 deficiency (6.9 ng/ml ; normal range : 28∼56 ng/ml). All of her symptoms resolved after treatment with thiamine hydrochloride (10 mg/day).
