Unusual painless upper limb ischemia in a patient with diabetes. A case study

Abstract

Diabetic neuropathy is a troublesome complication of diabetes mellitus. It affects about 50% of patients with diabetes and may mask symptoms of ischemic conditions. Sudden blockade in blood flow to the limb known as acute limb ischemia (ALI) is a life-threatening disease associated with peripheral artery disease (PAD). Diabetes mellitus predisposes both to ALI and PAD, while also delaying recognition due to diabetic peripheral neuropathy.We report a case of a patient with poorly controlled type 2 diabetes and atrial fibrillation who presented a rare occurrence of painless acute upper limb ischemia. Despite two embolectomies with positive revascularization, ischemia progressed, leading to amputation.In the article we discuss management of the patient and the case’s similarity to diabetic foot disease. Our case report highlights the importance of vigilance against diabetes-related complications, which may manifest unusual symptoms and thus mask other dangerous ailments.