A Hidden Complication of Poorly Managed Diabetic Control: A Case of Diabetic Myonecrosis

Abstract

Diabetic myonecrosis is an infrequently encountered complication of poorly managed type 2 diabetes. Despite its relative rarity, early detection and appropriate management can yield favorable outcomes. This case report details the presentation, diagnosis, and management of a 53-year-old male patient with a history of type 2 diabetes who presented with acute-onset pain, swelling of the muscles, and weakness. Following a battery of laboratory investigations, radiological imaging, and a muscle biopsy, the patient was diagnosed with diabetic myonecrosis. The patient was treated conservatively with analgesics, physiotherapy, and optimization of glycemic control, significantly improving muscle strength and function. This case highlights the necessity of considering diabetic myonecrosis as a potential differential diagnosis in diabetic patients who present with sudden muscle weakness and discomfort.

Keywords: diabetes mellitus; diabetic myonecrosis; glycemic control; muscle infarction; primary muscle disease.

Figure 1. Histopathology image of thigh muscle biopsy.

(1) Necrotic muscle fibers (swollen and eosinophilic and lack striations and nuclei). (2) Infarcted patch of myocytes.