Blurred vision and sudden...

A 56-year-old female was admitted to the Emergency Department complaining of blurred vision and sudden weight loss. She had an 8-month history of fatigue, polyuria, and polydipsia. On physical examination, a BMI of 21 kg/m2 was noted. On laboratory testing, an HbA1c of 15.4% confirmed diabetes mellitus and administration of basal-bolus insulin therapy was commenced. After eight months, the patient complained of severe paraesthesia associated with arm, shoulder and leg pain. Glucose readings had improved on insulin, with readings between 5 and 7 % further endoscopic examination of the duodenum and stomach normal pathology.