Korean J Clin Neurophysiol.  2014 Jun;16(1):8-14. 10.14253/kjcn.2014.16.1.8.

Peripheral Nerve Abnormalities in Patients with Newly Diagnosed Type I and II Diabetes Mellitus

Affiliations
  • 1Department of Neurology, Chungbuk National University School of Medicine, Cheongju, Korea. pnsdoctor@gmail.com
  • 2Department of Pediatrics, Chungbuk National University School of Medicine, Cheongju, Korea.
  • 3Department of Preventive Medicine, Chungbuk National University School of Medicine, Cheongju, Korea.

Abstract

BACKGROUND
Early detection of neuropathy may prevent further progression of this complication in the diabetic patients. The purpose of this study was to evaluate the prevalence of early neuropathic complication in patients with newly diagnosed type 1 and type 2 diabetes.
METHODS
Nerve conduction studies (median, ulnar, posterior tibial, peroneal, and sural nerves) were performed for 49 type 1 (27 males, mean 14.1+/-7.5 years) and 40 type 2 (27 males, 42.0+/-14.1 years) diabetic patients at onset of diabetes. Children with age at onset under 4 years and adults over 55 years were excluded to eliminate the aging effect and the influence of obstructive arteriosclerosis. Neuropathy was defined as abnormal nerve conduction findings in two or more nerves including the sural nerve.
RESULTS
Mean HbA1c level was 12.6+/-3.3% for type 1 and 10.5+/-2.9% for type 2 diabetes. The prevalence of neuropathy was 12.2% for type 1, and 35.0% for type 2 diabetes, respectively. There were significant trends in the prevalence of neuropathy with increasing age (p<0.05). The effect of the mean level of glycosylated hemoglobin on the prevalence of polyneuropathy at onset of diabetes was borderline (p=0.0532). Neither sex of the patients nor the type of diabetes affected the neurophysiologic abnormalities at the diagnosis.
CONCLUSIONS
Even in a population with diabetes at the diagnosis, the prevalence of subclinical neuropathy was not low. Neuropathy has been significantly associated with increasing age indicating the possibility of longer duration of undetected diabetes among them, especially in type 2 diabetes.

Keyword

Diabetes mellitus; Diabetic polyneuropathy; Prevalence; Type 1 diabetes; Type 2 diabetes; Nerve conduction study

MeSH Terms

Adult
Aging
Arteriosclerosis
Child
Diabetes Mellitus*
Diabetic Neuropathies
Diagnosis
Hemoglobin A, Glycosylated
Humans
Male
Neural Conduction
Peripheral Nerves*
Polyneuropathies
Prevalence
Sural Nerve

Reference

1.Meltzer S., Leite L., Daneman D., Gerstein HC., Lau D., Ludwig S, et al. Clinical practice guidelines of the management of diabetes in Canada. Canadian Diabetes Association. CMAJ. 1998. 159(Suppl 8):): S1-S29.
2.Dyck PJ., Bushek W., Spring EM., Karnes JL., Litchy WJ., O'Brien PC, et al. Vibratory and cooling detection thresholds compared with other testsin diagnosing and staging diabetic neuropathy. Diabetes Care. 1987. 10:432–440.
3.Ficicloglu C., Aydina A., Haktan M., Kiziltan M. Peripheral neuropathy in children with insulin-dependent diabetes mellitus. Turk J Pediatr. 1994. 36:97–104.
4.Solders G., Thalme B., Aguirre-Aquino M., Brandt L., Berg U., Persson A. Nerve conduction and autonomic nerve function in diabetic children. A 10-year follow-up study. Acta Paediatr. 1997. 86:361–366.
Article
5.Dyck PJ. Detection, characterization, and staging of polyneuropathy: asessed in diabetics. Muscle Nerve. 1988. 11:21–32.
6.Oh SJ. Clinical Electromyography: Nerve Conduction Studies. 3rd ed.Philadelphia, Baltimore: Williams & Wilkins;2003. p. 37–135.
7.Lee S., Han H., Kim H. A 5-yr follow-up nerve conduction study for the detection of subclinical diabetic neuropathy in children with newly diagnosed insulin-dependent diabetes mellitus. Pediatric Diabetes. 2010. 11:521–528.
Article
8.England JD., Gronseth GS., Franklin G., Miller RG., Asbury AK., Carter GT, et al. Distal symmetric polyneuropathy: a definition for clinical research. Report of the American Academy of Neurology, the American Association of Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology. 2005. 64:199–207.
Article
9.Comi G., Canal N., Lozza L., Beccaria L., Meschi F., Vanini R, et al. Peripheral nerve abnormalities in newly-diagnosed diabetic children. Acta Diabetol Lat. 1986. 23:69–75.
Article
10.Lehtinen JM., Uusitupa M., Siitonen O., Pyörälä K. Prevalence of neuropathy in newly diagnosed NIDDM and nondiabetic control subjects. Diabetes. 1989. 38:1307–1313.
Article
11.Partanen J., Niskanen L., Lehtinen J., Mervaala E., Siitonen O., Uusitupa M. Natural history of peripheral neuropathy in patients with non-insulin-dependent diabetes mellitus. N Engl J Med. 1995. 333:89–94.
Article
12.Rota E., Quadri R., Fanti E., Poglio F., Paolasso I., Ciaramitaro P, et al. Clinical and electrophysiological correlations in type 2 diabetes mellitus at diagnosis. Diabetes Res Clin Pract. 2007. 76:152–154.
Article
13.Karmakar RN., Khandakar MR., Gangopadhyay PK., Ghosh K., Babu AS. Albuminuria and neuropathy in newly detected diabetics: profile and correlation. J Indian Med Assoc. 2011. 109:396–399.
14.Daube JR. Electrophysiologic testing in diabetic neuropathy. Dyck PJ, Thomas PK, editors. Diabetic neuropathy. 2nd ed.Philadelphia: WB Saunders;1999. p. 222–238.
15.Sima AA., Kamiya H. Diabetic neuropathy differs in type 1 and type 2 diabetes. Ann NY Acad Sci. 2006. 1084:235–249.
Article
16.Kempler P., Tesfaye S., Chaturvedi N., Stevens LK., Webb DJ., Eaton S, et al. Autonomic neuropathy is associated with increased cardiovascular risk factors: the EURODIABIDDM Complications Study. Diabet Med. 2002. 19:900–909.
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