{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:55:36Z","timestamp":1790571336489,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose of Review<\/jats:title>\n                    <jats:p>Diabetes therapeutics can lower glycated haemoglobin (HbA1c) by several percentage points within weeks. While long\u2010term microvascular risk is reduced by improved glycaemia, abrupt metabolic transitions may destabilise tissues adapted to chronic hyperglycemia. We review treatment\u2010induced neuropathy of diabetes (TIND) and active Charcot neuro\u2010osteoarthropathy (CNO) as two neurovascular complications reported after rapid glycaemic correction, and we propose a unifying \u2018metabolic tempo\u2019 framework for prevention and early detection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent Findings<\/jats:title>\n                    <jats:p>TIND is an acute, painful small\u2010fibre and autonomic neuropathy occurring within 2\u20138\u00a0weeks after large HbA1c reductions, frequently coinciding with early worsening of retinopathy and nephropathy. Human in vivo nerve imaging demonstrates epineurial arteriovenous shunting and proliferative, leaky microvessels, supporting a microvascular dysregulation\/ischaemia\u2010reperfusion model. For CNO, causal evidence linking rapid glycaemic improvement to disease onset remains limited and mainly observational; however, multiple case reports (including pregnancy, post\u2010transplantation, and major weight loss contexts) and retrospective cohorts suggest that major glycaemic \u2018deceleration\u2019 may cluster in the months preceding active CNO in susceptible patients with long\u2010standing neuropathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Rapid glycaemic correction should not be avoided when urgently needed, but \u2018tempo\u2010aware\u2019 strategies may be warranted in microvascularly fragile patients (very high baseline HbA1c, established neuropathy\/retinopathy, kidney disease, or major weight loss). We outline pragmatic risk stratification, surveillance, and interdisciplinary pathways (neurology\u2010podiatry\u2010ophthalmology\u2010nephrology) to reduce delayed diagnosis and prevent deformity and disability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70210","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:54:16Z","timestamp":1787226856000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["When Glycaemic Control Comes Too Fast: Treatment\u2010Induced Neuropathy of Diabetes and Charcot Neuro\u2010Osteoarthropathy as Emerging Iatrogenic Complications of Rapid Metabolic Correction"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7172-4300","authenticated-orcid":false,"given":"Dured","family":"Dardari","sequence":"first","affiliation":[{"name":"Diabetology Department Centre Hospitalier Sud Francilien  Corbeil\u2010Essonnes France"},{"name":"Laboratoire de Biologie de l'Exercice pour la Performance et la Sant\u00e9 Universit\u00e9 d\u2019Evry IRBA Universit\u00e9 Paris\u2010Saclay  Evry France"},{"name":"Kremlin Bic\u00eatre Medical School Universit\u00e9 Paris\u2010Saclay  Kremlin Bicetre France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awu307"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13538"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2017.10.014"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20\u20102646"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2026.101737"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0233168"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc\u20102021\u2010002380"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/a\u20102498\u20106826"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3646"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892\u2010017\u20100960\u20106"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2020.102668"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21952"},{"key":"e_1_2_15_14_1","first-page":"745","article-title":"Insulin Neuritis: A Case Report","volume":"59","author":"Caravati C. 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