The impacts of poor glycemic control and disease duration on peripheral nerves in children and adolescents with type 1 diabetes mellitus

Authors

  • Müge Ayanoğlu Aydın Adnan Menderes University, School of Medicine, Department of Pediatric Neurology
  • Prof. Dr. Uluç Yiş Dokuz Eylül University, School of Medicine, Department of Pediatric Neurology
  • Associate Professor Hale Ünver Tuhan Dokuz Eylül University, School of Medicine, Department of Pediatric Endocrinology
  • Dr. Ayşe İpek Polat Dokuz Eylül University, School of Medicine, Department of Pediatric Neurology
  • Dr. Tuncay Derya Okur Dokuz Eylül University, School of Medicine, Department of Pediatric Neurology
  • Dr. Pınar Edem Dokuz Eylül University, School of Medicine, Department of Pediatric Neurology
  • Dr. Cem Paketçi Dokuz Eylül University, School of Medicine, Department of Pediatric Neurology
  • Associate Professor Erhan Bayram Dokuz Eylül University, School of Medicine, Department of Pediatric Neurology
  • Prof. Dr. Ayhan Abacı Dokuz Eylül University, School of Medicine, Department of Pediatric Endocrinology
  • Prof. Dr. Semra Hız Dokuz Eylül University, School of Medicine, Department of Pediatric Neurology

DOI:

https://doi.org/10.54029/2022fxx

Keywords:

Diabetic neuropathy, glycemic variability, poor-glycemic control, type 1 diabetes mellitus, children, adolescents

Abstract

Objective: To evaluate the risk factors of subclinical neuropathy, and the nerve conduction study (NCS) results in children, and adolescents with type 1 diabetes mellitus (T1DM).

Methods: A total of 81 patients without neuropathy symptoms were studied. Demographical features, pubertal stage, disease duration, NCS results, lipid profile results in the last 2 years, HbA1c results in the last 5 years, and the types of treatments (multiple-dose and insulin pump therapy) were recorded.

Results: The median age was 14 (5) years, 49.3 % (n=40) of the study group was female and 81.5 % (n=66) of the patients were pubertal. Of the patients, 16.04% had abnormal NCS results. There were no significant differences between patients with normal and abnormal NCS results in terms of demographical features, pubertal stage, disease duration, lipid profiles, and dysglycemia. No significant differences were found between the types of treatment in terms of NCS results. The proximal and distal compound muscle action potential (CMAP) amplitudes of the median nerve were significantly lower in patients with poor glycemic control than in those with well-glycemic control. Sensory nerve action potential (SNAP) amplitudes of sural nerve were significantly lower in patients whose disease durations were ≥60 months than in those <60 months.

Conclusions: About a sixth of the T1DM has subclinical neuropathy. CMAP amplitudes of the median nerve are the most affected measurement from poor-glycemic control. Additionally, SNAP amplitudes of the sural nerve are the values most affected by longer disease duration.

Published

2022-07-04

Issue

Vol. 27 No. 2 (2022)

Section

Original Article