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[Diabetic papillopathy after intensification of insulin therapy: A case report]
I Sebai1, M Chihaoui1, E Elfeleh1
1Service d'endocrinologie, hôpital La Rabta, faculté de médecine de Tunis, université Tunis, El Manar, Tunisie.
Introduction:
Diabetic papillopathy is a rare ocular complication of diabetes. Its pathophysiology is not well known. It is a unilateral or bilateral optic disc edema with variable degrees of visual loss.
Observation:
A 66-year-old woman, with a twelve years old type 2 diabetes mellitus, suddenly presented a unilateral decreased vision. Her ocular examination was normal eight months earlier. Ocular examination, radiological investigations and laboratory analysis were conclusive of diabetic papillopathy. Medical history revealed a recent rapid improvement of blood glucose control after intensification of insulin therapy. A visual acuity improvement with spontaneous regression of papillary edema was observed.
Conclusion:
There is a risk of diabetic papillopathy associated with the rapid control of blood glucose levels after intensification of insulin therapy, even in diabetic patients without known retinopathy.
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