A 54-year-old woman presented with complaints of pain in both legs (calf and thigh), mostly at night. She has an H/o Type II diabetes managed with metformin 500mg with glimepiride 2 mg before lunch and dinner. Family history includes coronary artery disease and types II diabetes in mother and hypertension in father. Examination reports are as follows:

  • Height & weight: 155 cm; 68 kg 
  • Blood pressure: 130/78 mmHg; Respiratory rate: 12/minute; Pulse rate: 76/minute 
  • HbA1c: 7.2% (Fasting: 140 mg/dL; PP: 192 mg/dL)
  • LDL: 124 mg/dL; TG: 170 mg/dL; HDL: 50 mg/dL
  • Serum Vitamin E levels: 2 mg/L.
  • The CBC and liver function test reports were normal.

 

The patient was diagnosed to be vitamin E deficient. 

Therefore, the therapy included vitamin E 200mg capsules twice- daily and lifestyle modification and diabetic medication. During follow up after two weeks, the patient showed improvement in pain. In addition, blood evaluation reports indicated significant improvement in lipid profile, blood glucose level, and vitamin E levels.

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