Diabetic 65 Year old wome...

A 65-year-old woman presented with a 1-year H/O polyuria, and polydipsia, blurred vision. Recently, lost 7 kg weight and reported fatigue. A BMI of 28 kg/m2 and reduced peripheral vibration on both feet was revealed on physical examination. HbA1c was 140 mmol/mol (15.0%) on blood glucose level examination with a confirmed DM diagnosis. Resolution of hyperglycaemias was made with the administration of basal-bolus insulin. Eventually, insulin was discontinued, and metformin 1000 mg twice a day and gliclazide modified release of 30 mg a day has been prescribed. The patient complained of severe left-sided groin pain radiating down his left leg and associated left leg weakness three months later. There is a further reduction of 3kg weight regardless of glycaemic control. On examination, left hip flexion and left knee extension showed a weakness with an absence of left patellar reflex. On nerve conduction and EMG examination revealed left-sided lumbosacral plexopathy affecting quadriceps muscles.