A Community-Identified, Neglected Case of Poorly Controlled Diabetes Presenting with Persistent Furuncles — A Case Report

Abstract

Unhealed or recurrent skin infections may serve as early warning signs of poorly controlled diabetes, especially in underserved or overlooked populations. This case highlights how a seemingly simple complaint identified during a routine community visit revealed long-standing, uncontrolled diabetes that had gone unattended for years. Patient Concerns and Clinical Findings: A 30-year-old woman from an urban slum presented with a 15-day history of a non-healing furuncle on the lower back, with a new adjacent lesion. She reported symptoms of uncontrolled diabetes, including polyuria, polydipsia, polyphagia, weight loss, fatigue, pruritus vulvae, and tingling in her feet. Examination confirmed an active skin infection and features suggestive of early diabetic neuropathy. Primary Diagnosis, Interventions, and Outcomes: She was a known but poorly monitored case of T2DM for 7 years initially detected during Gestation (GDM)with coexisting hypothyroidism. Persistent hyperglycemia resulted from irregular follow-up and inadequate monitoring. She was referred for complete glycemic evaluation, counselled on wound care, diet, physical activity, and adherence, and advised to continue oral hypoglycemics and thyroid hormone therapy with regular follow-up. However, outcome assessment was limited as she was later lost to follow-up. This case demonstrates how chronic, poorly controlled diabetes may remain hidden in the community and present through avoidable complications such as furunculosis. Missed follow-ups, inadequate monitoring, and low health-seeking behavior contribute to persistent hyperglycemia. Routine community outreach remains vital in early detection, linkage to care, and prevention of long-term complications in vulnerable populations.