Endocrine Abstracts

Diabetes mellitus (DM) is a prevalent chronic disease often diagnosed through routine screening or the manifestation of typical symptoms like polyuria and polydipsia. However, it is rare for diabetic neuropathic complications, such as foot ulcers, to be the initial presentation, especially in the absence of other medical conditions. This case report discusses a 53-year-old female who presented with a neuropathic foot ulcer, leading to the diagnosis of Type 2 Diabetes Mellitus (T2DM). A 53-year-old female was referred by her general practitioner (GP) to a diabetic foot clinic for evaluation of a neuropathic foot ulcer. The patient’s HbA1c level was measured for the first time following this referral and found to be 120 mmol/mol (13.1%), confirming a diagnosis of diabetes. The patient reported no significant past medical history or alcohol intake. She had experienced vague symptoms of polyuria for about a year but attributed them to post-menopausal changes and did not seek medical attention. Given the unusual presentation of T2DM with a neuropathic ulcer as the first symptom, differential diagnoses were thoroughly explored. Exclusions included vitamin B12 and folate deficiencies, anaemia, hypothyroidism, and autoimmune diseases, none of which were present. This case underscores the necessity for heightened public awareness regarding the early symptoms of diabetes to prompt timely medical consultation. Early detection and management are crucial to prevent severe complications. The case is particularly notable due to the rarity of a neuropathic ulcer being the initial presentation of T2DM in the current era of advanced medical screening and public health awareness. It highlights a gap in patient education and awareness about diabetes symptoms. This case advocates for enhanced public health initiatives to educate individuals on recognizing early diabetes symptoms, encouraging timely medical evaluation to prevent end-organ damage and improve long-term outcomes.