{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T14:05:44Z","timestamp":1777557944491,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes &amp; Vascular Disease Research"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>Diabetic neuropathy is a troublesome complication of diabetes mellitus. It affects about 50% of patients with diabetes and may mask symptoms of ischemic conditions. Sudden blockade in blood flow to the limb known as acute limb ischemia (ALI) is a life-threatening disease associated with peripheral artery disease (PAD). Diabetes mellitus predisposes both to ALI and PAD, while also delaying recognition due to diabetic peripheral neuropathy.<\/jats:p>\n                  <jats:p>We report a case of a patient with poorly controlled type 2 diabetes and atrial fibrillation who presented a rare occurrence of painless acute upper limb ischemia. Despite two embolectomies with positive revascularization, ischemia progressed, leading to amputation.<\/jats:p>\n                  <jats:p>In the article we discuss management of the patient and the case\u2019s similarity to diabetic foot disease. Our case report highlights the importance of vigilance against diabetes-related complications, which may manifest unusual symptoms and thus mask other dangerous ailments.<\/jats:p>","DOI":"10.1177\/14791641251380498","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T01:23:02Z","timestamp":1763428982000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unusual painless upper limb ischemia in a patient with diabetes. A case study"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4839-8922","authenticated-orcid":false,"given":"Jakub","family":"Pyrkosz","sequence":"first","affiliation":[{"name":"Wroc\u0142aw Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Augustynowicz","sequence":"additional","affiliation":[{"name":"Wroc\u0142aw Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7646-2354","authenticated-orcid":false,"given":"Micha\u0142","family":"Kisiel","sequence":"additional","affiliation":[{"name":"Wroc\u0142aw Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"Rabczy\u0144ski","sequence":"additional","affiliation":[{"name":"Wroc\u0142aw Medical University, Wroc\u0142aw,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawe\u0142","family":"Pochcia\u0142","sequence":"additional","affiliation":[{"name":"Wroc\u0142aw Medical University, Wroc\u0142aw,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Madziarska","sequence":"additional","affiliation":[{"name":"Wroc\u0142aw Medical University, Wroc\u0142aw,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70065-0"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-020-02145-7"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2017.07.006"},{"key":"e_1_3_3_5_2","unstructured":"Firnhaber JM Powell CS. Firnhaber - o PAD. Am Fam Physician; 99: 362\u2013369."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2019.09.006"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(97)70045-4"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yasu.2023.05.003"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-0998-4204"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semvascsurg.2008.12.004"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0279095"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1100\/2012\/673483"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.5090\/kjtcs.2015.48.4.246"},{"key":"e_1_3_3_14_2","unstructured":"Muhs B Muhs B Muhs B. Acute ischemic syndromes of the upper extremities. In: Lanzer P (ed). PanVascular Medicine. Springer."},{"key":"e_1_3_3_15_2","doi-asserted-by":"crossref","unstructured":"Olinic DM Stanek A T A et al. Acute limb ischemia: an update on diagnosis and management. 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