Bilaterale dropvoet als eerste presentatie van early-onset type 2 diabetes mellitus

Bilateral foot drop as the first presentation of early-onset type 2 diabetes mellitus Here we present the case of a 35-year-old man who presented to the emergency department with severe length-dependent sensorimotor polyneuropathy and bilateral foot drop as the first manifestation of type 2 diabetes mellitus (T2D). Screening for diabetes-related complications revealed advanced neurologic, ophthalmologic, and renal damage. The discrepancy between the patient’s young age and the already advanced organ damage constitutes the clinical core message of this case. Early-onset T2D, defined as a diagnosis of T2D before the age of 40 years, is characterized by a more aggressive phenotype with pronounced insulin resistance and accelerated β-cell failure. In addition, both microvascular and macrovascular complications often occur at a younger age, which is associated with reduced life expectancy. This case illustrates that T2D may present atypically, in this instance as a neurological emergency at a relatively young age. Early recognition and timely treatment are essential to prevent and limit further organ damage.