Advanced organ complications as the manifestation of undertreated diabetes mellitus in a 41- year old woman.

Overview

In a 37-year old woman with a history of diabetes mellitus (DM) from age 17 have developed advanced macro- and microvascular complications as a consequence of the untreated disorder. The patient was only temporarily treated from age 22 by insulin injections and shortly also by insulin pump. She was repeatedly pregnant in the following 5 year period, but the 2^nd pregnancy was interrupted because of a genetic malformation of foetus and the 3^rd pregnancy was terminated prematurely by Caesarean operation in order to remove a dead foetus. A probable cause of the spontaneous interruption of the 1st pregnancy was uncompensated DM. Intensive insulin treatment of the non-compliant diabetic patient was applied only when advanced organ complications of DM were diagnosed. Patient underwent laser coagulation of the retina in both eyes for the treatment of proliferative diabetic retinopathy and diabetic maculopathy. Subsequently, patient underwent pars plana vitrectomy in both eyes for the treatment of complications arising from proliferative form of the diabetic retinopathy.

Key words:
proliferative diabetic retinopathy, pars plana vitrectomy, active screening, pregnancy