Transient autonomic neuropathy in an adolescent with insulin dependent diabetes mellitus

A 15 year-old girl with insulin dependent diabetes mellitus of 11 years duration developed severe neuropathy involving the bladder and stomach. The bladder recovered after 2 months of intermittent catheterization. Metoclopramide relieved the gastric symptoms. Gastric emptying was normal after 2 further months of treatment. The neuropathy developed in spite of a mean HbA1c of 7.4% suggesting that factors in addition to glycemic control play a role in the development of the complications of insulin dependent diabetes mellitus.