Evidence for Diabetic Encephalopathy

Diabet Med. Feb-Mar 1991;8(2):162-7. doi: 10.1111/j.1464-5491.1991.tb01564.x.

Abstract

Auditory brain stem responses were recorded in 20 normoacoustic long-duration Type 1 diabetic patients (duration of diabetes 26 (range 13-46) years, age 44 (25-66) years) with peripheral neuropathy and retinopathy and in 19 sex-matched normoacoustic short-duration Type 1 diabetic patients (duration of diabetes 2 (0-6) years, age 23 (18-50) years) without clinical signs of neuropathy or microangiopathy. Abnormal brain stem auditory evoked responses were demonstrated in 40% of the long-duration and in 5.3% of the short-duration diabetic patients (p less than 0.01). Interpeak latencies Jv-JI and JIII-JI were significantly prolonged in both patient groups compared with the non-diabetic control group (p less than 0.01). Magnetic resonance imaging was performed in 16 of the long-duration patients and in 40 age-matched healthy volunteers on a whole body MR-scanner. Subcortical and/or brain stem lesions with abnormally high signals were seen in 69% of the long-duration Type 1 patients and in 12% of the healthy volunteers (p less than 0.02). Neuropsychological examination including 17 tests for intelligence and cognition were performed in the 20 long-duration Type 1 diabetic patients. The results indicated a performance close to that seen in a control group of healthy age-matched control subjects. Our study demonstrates that a considerable proportion of long-duration Type 1 diabetic patients suffering from retinopathy and peripheral neuropathy additionally have signs but no symptoms of central nervous system affection, diabetic encephalopathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Blood Pressure
  • Brain Stem / physiopathology*
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetes Mellitus, Type 1 / psychology
  • Diabetic Nephropathies / physiopathology
  • Diabetic Neuropathies / diagnosis
  • Diabetic Neuropathies / physiopathology*
  • Diabetic Neuropathies / psychology
  • Diabetic Retinopathy / physiopathology
  • Evoked Potentials, Auditory*
  • Glycated Hemoglobin A / analysis
  • Heart Rate
  • Humans
  • Learning
  • Magnetic Resonance Imaging
  • Memory
  • Neuropsychological Tests
  • Vibration

Substances

  • Blood Glucose
  • Glycated Hemoglobin A