Reversal of neuropathic and gastrointestinal complications related to diabetes mellitus in adolescents with improved metabolic control.

Two adolescents with insulin-dependent diabetes mellitus developed unusually severe diabetic neuropathy which responded to intensive measures to achieve improved metabolic control. Employing home blood glucose monitoring and either frequent insulin injections or a portable insulin infusion pump, painful peripheral neuropathy and autonomic gastrointestinal neuropathy improved after five and 12 months of therapy, respectively. During this period of time, abnormal ocular fluorophotometry, an early change in the eye of diabetic patients, also returned to normal. These patients demonstrate the reversibility of unusually severe neuropathy and early ocular changes in adolescents with diabetes when treated with intensive measures designed to improve metabolic control.