Amyotrophy in young diabetics: clinical profiles

Seven young patients presenting with diabetic amyotrophy, unusual at their age, are described. Besides symptoms suggestive of proximal muscle weakness and occasionally of diabetes, all patients were underweight; abdominal pain occurred in all the patients. The diagnosis of amyotrophy was confirmed on electromyography and nerve conduction studies in all patients, and muscle biopsy in two patients. All patients recovered fully on control of diabetes with insulin. Only two episodes of stress induced ketosis were recorded in these 7 patients. These patients were not ketotic though they were severely uncontrolled on omission of insulin. They had normal lipid levels, and had no other complications of diabetes. Pancreatic calculi were found in only one patient. We describe here the clinical profiles of these patients and discuss the possible aetiologies of diabetes and the clinical implications.