It is widely held that neuropathy in diabetes always follows a prolonged period of poor control of the disease. Joslin states that "true diabetic neuritis in most, if not all, instances follows a period of uncontrolled diabetes." According to Duncan, "peripheral neuritis in diabetes is a common complication of grossly neglected diabetes over long periods"; and Rundles insists that the onset of diabetic neuropathy always occurs when the diabetes is not under control.
Ellenberg1 studied a large group of patients with diabetic neuropathy and noted a number of inconsistencies in this view. Among his diabetics with neuropathy he observed a number of patients whose diabetes was well controlled. Other clinicians have made the same observation. It has been noted that diabetes was diagnosed at the time of onset of the neuropathic symptoms. The neuritic symptoms dominated the clinical picture in these patients, and only the history elicited a relatively
DIABETIC NEUROPATHY. JAMA. 1960;174(17):2147–2148. doi:10.1001/jama.1960.03030170037010