Endocrine Abstracts

Introduction: The diagnosis of diabetes often precedes the onset of degenerative complications.

Method: We report the case of a patient who had consulted for a poor foot plantar perforation evolving for 3 months before the diagnosis of diabetes.

Results: He is a 57-year-old active smoking patient with a family history of diabetes and hypertension who presented to the emergency department of the Tunis National Nutrition Institute for inaugural diabetic ketosis with a ‘lesion’ of the foot evolving for 3 months which does not heal. On examination, he had a BMI = 27.4 kg/m², stable hemodynamic constants, an uninfected plantar neuropathic ulcer, and neuro-ischemic feet. In biology he had an HbA1C = 13.1%, a clearance creatinine = 102.5 ml/min (CKD-EPI). He did not have a biological infectious syndrome. The ophthalmological examination had diagnosed diabetic retinopathy. The patient was put on insulin therapy associated to metformin.

Conclusion: In our case, the appearance of the plantar neuropathic ulcer preceded the diagnosis of diabetes by 3 months. Screening for diabetes in people at risk should be systematic to avoid such cases.