{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:58:57Z","timestamp":1785164337717,"version":"3.55.0"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Osmotic demyelination syndrome (ODS) is classically associated with rapid correction of hyponatremia; however, non-sodium osmotic shifts remain underrecognized. We report a young man with poorly controlled type 1 diabetes and extreme glycemic variability (13\u2013486\u00a0mg\/dL), admitted with cardiorenal syndrome requiring dialysis, who developed progressive neurological deficits. Brain MRI demonstrated findings consistent with extrapontine ODS despite stable sodium levels. Alternative etiologies were excluded, supporting glycemic variability and osmotic instability as key contributors, potentially exacerbated by dialysis disequilibrium. This case expands the pathophysiological spectrum of ODS and highlights glycemic variability as a clinically relevant, yet overlooked, risk factor.<\/jats:p>","DOI":"10.1093\/omcr\/omag138","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T11:42:19Z","timestamp":1784288539000},"source":"Crossref","is-referenced-by-count":0,"title":["Osmotic demyelination without hyponatremia: the role of glycemic variability in a complex patient with diabetes"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1752-3804","authenticated-orcid":false,"given":"Juliana","family":"Pineda-Ortega","sequence":"first","affiliation":[{"name":"Departamento de Medicina Interna , , Carrera 7 No. 40-62, Bogot\u00e1 ,","place":["Colombia"]},{"name":"Hospital Universitario San Ignacio , , Carrera 7 No. 40-62, Bogot\u00e1 ,","place":["Colombia"]},{"name":"Facultad de Medicina, Departamento de Medicina Interna , , Carrera 7 No. 40-62, Bogot\u00e1 \u00a0","place":["Colombia"]},{"name":"Pontificia Universidad Javeriana , , Carrera 7 No. 40-62, Bogot\u00e1 \u00a0","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Juliana","family":"Soto-Chavez","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Interna , , Carrera 7 No. 40-62, Bogot\u00e1 ,","place":["Colombia"]},{"name":"Hospital Universitario San Ignacio , , Carrera 7 No. 40-62, Bogot\u00e1 ,","place":["Colombia"]},{"name":"Facultad de Medicina, Departamento de Medicina Interna , , Carrera 7 No. 40-62, Bogot\u00e1 \u00a0","place":["Colombia"]},{"name":"Pontificia Universidad Javeriana , , Carrera 7 No. 40-62, Bogot\u00e1 \u00a0","place":["Colombia"]},{"name":"Hospital Universitario San Ignacio, Unidad de Endocrinolog\u00eda , Carrera 7 No. 40-62, Bogot\u00e1 ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Mar\u00eda","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Departamento de Medicina Interna , , Carrera 7 No. 40-62, Bogot\u00e1 ,","place":["Colombia"]},{"name":"Hospital Universitario San Ignacio , , Carrera 7 No. 40-62, Bogot\u00e1 ,","place":["Colombia"]},{"name":"Facultad de Medicina, Departamento de Medicina Interna , , Carrera 7 No. 40-62, Bogot\u00e1 \u00a0","place":["Colombia"]},{"name":"Pontificia Universidad Javeriana , , Carrera 7 No. 40-62, Bogot\u00e1 \u00a0","place":["Colombia"]},{"name":"Hospital Universitario San Ignacio, Unidad de Endocrinolog\u00eda , Carrera 7 No. 40-62, Bogot\u00e1 ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"2026072710003794200_ref1","author":"D\u00eda mundial de la diabetes 2023 - 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