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Diabetic muscle infarction is a rare but under-reported complication of diabetes mellitus. The condition characteristically affects poorly-controlled type 1 diabetic patients with severe microvascular complications. In most of the reported cases, patients have not presented until several weeks into the illness and serum creatine kinase levels were not elevated. We describe a case of diabetic muscle infarction occurring in a type 2 diabetic patient with no evidence of significant retinopathy, neuropathy or nephropathy. Due to the acute presentation of our patient, we are able to demonstrate a large rise in serum creatine kinase levels not previously seen. Copyright © 2005 John Wiley & Sons, Ltd.