Profound weight loss in a type 2 diabetic patient with diabetic neuropathic cachexia: a case report.

A 35-year-old morbidly obese man, diagnosed with type 2 diabetes in 2006, lost nearly 100 kg extremely rapidly soon after the diagnosis, with dramatic painful paraesthesia and autonomic neuropathy, and poor diabetes control. Investigations to find a tumour, or an infectious, endocrinological or digestive disease, to explain his clinical features were all negative. However, with insulin and analgesic treatment, the patient's symptoms improved markedly within a few months; the patient gained 50 kg, while insulin was tapered and then withdrawn, to be replaced by metformin, which maintained perfect diabetes control. Also, the analgesic therapies could be discontinued. This case report is typical of diabetic neuropathic cachexia, first described by Ellenberg in 1974.