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Diabetic muscle infarction: a systematic review
William B Horton1, Jeremy S Taylor1, Timothy J Ragland2
1Department of Medicine , University of Mississippi Medical Center , Jackson, Mississippi , USA.
Context:
Diabetic muscle infarction (DMI) is a rare complication associated with poorly controlled diabetes mellitus. Less than 200 cases have been reported in the literature since it was first described over 45 years ago. There is no clear 'standard of care' for managing these patients.
Evidence Acquisition:
PubMed searches were conducted for 'diabetic muscle infarction' and 'diabetic myonecrosis' from database inception through July 2014. All articles identified by these searches were reviewed in detail if the article text was available in English.
Evidence Synthesis:
The current literature exists as case reports or small case series, with no prospective or higher-order treatment studies available. Thus, an evidence-based approach to data synthesis was difficult. The available literature is presented objectively with an attempt to describe clinically relevant trends and findings in the diagnosis and management of DMI.
Conclusions:
Early recognition of DMI is key, so appropriate treatment can be initiated. MRI is the radiological study of choice. A combination of bed rest, glycemic control, and non-steroidal anti-inflammatory drug therapy appears to yield the shortest time to symptom resolution and the lowest risk of recurrence.
Insights
Diabetic muscle infarction (DMI) is a rare diabetes complication. Early recognition and treatment with rest, glycemic control, and NSAIDs offer the best outcomes for DMI patients.
Area of Science:
- Endocrinology
- Musculoskeletal Medicine
- Radiology
Background:
- Diabetic muscle infarction (DMI) is a rare complication of poorly controlled diabetes mellitus, with fewer than 200 cases reported in over 45 years.
- No established standard of care exists for managing DMI patients.
Purpose of the Study:
- To review and synthesize available literature on the diagnosis and management of diabetic muscle infarction.
- To identify clinically relevant trends and findings in DMI cases.
Main Methods:
- Systematic literature search of PubMed for 'diabetic muscle infarction' and 'diabetic myonecrosis' up to July 2014.
- Detailed review of all available English-language articles, prioritizing case reports and series due to lack of higher-order studies.
Main Results:
- The literature on DMI primarily consists of case reports and small case series, lacking prospective or higher-order treatment studies.
- An evidence-based synthesis was challenging due to the nature of available data.
- Clinical trends in DMI diagnosis and management were extracted from the reviewed literature.
Conclusions:
- Early recognition of diabetic muscle infarction is crucial for timely and effective treatment.
- Magnetic Resonance Imaging (MRI) is the preferred diagnostic imaging modality for DMI.
- A management approach combining bed rest, improved glycemic control, and non-steroidal anti-inflammatory drugs (NSAIDs) is associated with faster symptom resolution and reduced recurrence risk.
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