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Chronic hyponatremia associated with diabetic amyotrophy
Archives of Internal Medicine
|March 1, 1986
Summary
Diabetic patients with unexplained hyponatremia and weight loss may have a benign condition called diabetic amyotrophy. This condition is not linked to malignancy and resolves with treatment.
Area of Science:
- Endocrinology
- Nephrology
- Neurology
Background:
- Hyponatremia in diabetic patients is often attributed to hyperglycemia, medications, or other factors.
- Diabetic amyotrophy is a rare complication of diabetes mellitus.
Observation:
- Two insulin-treated type II diabetic patients presented with severe weight loss, hyponatremia, and diabetic amyotrophy despite good metabolic control.
- Laboratory findings suggested the syndrome of inappropriate antidiuretic hormone secretion (SIADH).
Findings:
- Despite initial suspicion of malignancy, both patients experienced resolution of hyponatremia with treatment (demeclocycline or fluid restriction/furosemide) and weight gain.
- Diabetic amyotrophy resolved within four to six months.
- No evidence of malignancy was found after 24–36 months of follow-up.
Implications:
- This case series suggests that diabetic amyotrophy can present with hyponatremia and is a benign condition.
- Diabetic amyotrophy should be considered in the differential diagnosis of chronic hyponatremia in diabetic patients.
- This entity is distinct from malignancy-associated hyponatremia.