Isabella Walter-Höliner1, Daniela Seick Barbarini2, Jürg Lütschg2, Anya Blassnig-Ezeh2, Ulrike Zanier3, Christoph H Saely4, Burkhard Simma2. 1. Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria. Electronic address: isabella.walter@vol.at. 2. Department of Pediatrics, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria. 3. Department of Pediatrics, Krankenhaus der Stadt Dornbirn, Dornbirn, Austria. 4. Department of Medicine and Cardiology, Academic Teaching Hospital, Landeskrankenhaus Feldkirch, Feldkirch, Austria; Vorarlberg Institute for Vascular Investigation and Treatment, Vorarlberg, Austria.
Abstract
BACKGROUND: In this prospective cohort study, we investigated the prevalence of diabetic peripheral neuropathy at baseline and after five years of follow-up in children and adolescents with type 1 diabetes mellitus using both measurements of nerve conduction velocity and clinical neurological examination. METHODS: A total of 38 patients who underwent insulin pump or intensive insulin therapy were included. The subjects averaged 12.6 ± 2.4 years of age and their diabetes duration averaged 5.6 ± 3.2 years. All patients underwent a detailed physical, neurological, and electrophysiological examination, as well as laboratory testing at their annual checkup. RESULTS: At baseline, the prevalence of diabetic peripheral neuropathy diagnosed using neurological examination was 13.2%, whereas nerve conduction velocity testing revealed diabetic peripheral neuropathy in 31.6%, highlighting a high prevalence of subclinical diabetic peripheral neuropathy. During follow-up, there was a strong increase in the prevalence of clinically diagnosed diabetic peripheral neuropathy, which reached 34.2% (P = 0.039) after five years; the proportion of patients with subclinical diabetic peripheral neuropathy even reached 63.2% (P = 0.002). The most significant changes in electrophysiological parameters were observed in the tibial sensory nerve (P = 0.001). CONCLUSIONS: The prevalence of diabetic peripheral neuropathy in children and adolescents with type 1 diabetes mellitus was high, and there was a rapid increase in the prevalence of diabetic peripheral neuropathy during a five-year follow-up interval. Importantly, our data show that a mere clinical evaluation is not sensitive enough to diagnose diabetic peripheral neuropathy in these patients. Nerve conduction velocity measurement, which is regarded as the gold standard for the assessment of diabetic peripheral neuropathy, should be applied more broadly.
BACKGROUND: In this prospective cohort study, we investigated the prevalence of diabetic peripheral neuropathy at baseline and after five years of follow-up in children and adolescents with type 1 diabetes mellitus using both measurements of nerve conduction velocity and clinical neurological examination. METHODS: A total of 38 patients who underwent insulin pump or intensive insulin therapy were included. The subjects averaged 12.6 ± 2.4 years of age and their diabetes duration averaged 5.6 ± 3.2 years. All patients underwent a detailed physical, neurological, and electrophysiological examination, as well as laboratory testing at their annual checkup. RESULTS: At baseline, the prevalence of diabetic peripheral neuropathy diagnosed using neurological examination was 13.2%, whereas nerve conduction velocity testing revealed diabetic peripheral neuropathy in 31.6%, highlighting a high prevalence of subclinical diabetic peripheral neuropathy. During follow-up, there was a strong increase in the prevalence of clinically diagnosed diabetic peripheral neuropathy, which reached 34.2% (P = 0.039) after five years; the proportion of patients with subclinical diabetic peripheral neuropathy even reached 63.2% (P = 0.002). The most significant changes in electrophysiological parameters were observed in the tibial sensory nerve (P = 0.001). CONCLUSIONS: The prevalence of diabetic peripheral neuropathy in children and adolescents with type 1 diabetes mellitus was high, and there was a rapid increase in the prevalence of diabetic peripheral neuropathy during a five-year follow-up interval. Importantly, our data show that a mere clinical evaluation is not sensitive enough to diagnose diabetic peripheral neuropathy in these patients. Nerve conduction velocity measurement, which is regarded as the gold standard for the assessment of diabetic peripheral neuropathy, should be applied more broadly.
Authors: Hoda Gad; Bara Al-Jarrah; Saras Saraswathi; Ioannis N Petropoulos; Georgios Ponirakis; Adnan Khan; Parul Singh; Souhaila Al Khodor; Mamoun Elawad; Wesam Almasri; Hatim Abdelrahman; Ahmed Elawwa; Amel Khalifa; Ahmed Shamekh; Fawziya Al-Khalaf; Goran Petrovski; Mahmoud Al Zyoud; Maryam Al Maadheed; Mohamed A Hendaus; Khalid Hussain; Anthony K Akobeng; Rayaz A Malik Journal: J Diabetes Investig Date: 2020-07-07 Impact factor: 4.232
Authors: Anna Vágvölgyi; Ágnes Maróti; Mónika Szűcs; Csongor Póczik; Dóra Urbán-Pap; István Baczkó; Attila Nemes; Éva Csajbók; Krisztián Sepp; Péter Kempler; Andrea Orosz; Tamás Várkonyi; Csaba Lengyel Journal: Front Endocrinol (Lausanne) Date: 2021-08-27 Impact factor: 5.555