Abstract
We report a 50-year-old man who developed painful neuropathy after treatment with an oral hypoglycemic drug. Although the duration of the NIDDM was unknown, he had a two-year history sensory disturbance of the lower extremities.
Diet therapy and oral hypoglycemic agent were prescribed after admission. Although his blood glucose level normalized in 2 weeks, he suffered dysesthetic pain in the foot and a gait disturbance. At that time, the blood study results were normal. No sensory nerve action potentials were detected electromyographically in the sural nerves, and left sural nerve biopsy was performed. The light microscopic findings were compatible with diabetic neuropathys, But electron microscopy showed very few regenerating fibers. Although the pain of diabetic neuropathy has been attributed to the sprouting of unmyelinated and small myelinated fibers, our case suggests that the cause of painful diabetic neuropathy might be related not only to the regeneration of small fibers in the peripheral nerves, but to other causes as well.
