A 34-year-old man presented with type 1 diabetes mellitus (DM), who was on insulin treatment for the past 30 years, and had poor glycaemic control due to non-compliance with glycated haemoglobin averaging 13%. DM was complicated with peripheral vascular disease (PVD), peripheral sensory neuropathy (PSN), diabetic retinopathy and nephropathy leading to end-stage renal disease with haemodialysis vintage of 2 years. He presented with excruciating pain and progressive discolouration involving several digits over 3 months (figure 1). Apart from a history of multiple fractures, there was no fever, arthralgia …
