Rhabdomyolysis and diabetes: a mitochondrial connection

The authors present a case report of a patient with type 1 diabetes mellitus and new-onset rhabdomyolysis. This case highlights the need to consider mitochondrial disease in patients with diabetes mellitus and neurologic abnormalities, especially those with a maternal family history of diabetes mellitus. In patients with diabetes who present with rhabdomyolysis unrelated to other known causes, the presence of mitochondrial disease should also be strongly considered. The diagnosis of mitochondrial disorders has implications for both treatment strategies and genetic counseling. A 23-year-old white man with a history of type 1 diabetes mellitus initially diagnosed at age 20 years was in his usual state of health until he noticed muscle aches after restarting his weight-lifting exercises. One month after the patient's hospitalization for rhabdomyolysis, his laboratory test results were unremarkable, with normal CK, creatinine, electrolytes, liver function, morning cortisol, and thyroid-stimulating hormone (thyrotropin). Islet cell and glutamic acid decarboxylase (GAD)-65 antibodies were negative.