Subclinical nerve dysfunction in children and adolescents with IDDM

Diabetologia. 1995 Jun;38(6):685-92. doi: 10.1007/BF00401840.

Abstract

The purpose of this study was to investigate whether young insulin-dependent diabetic patients still develop peripheral nerve dysfunction when using modern multiple insulin injection therapy and to elucidate if this correlated with various disease parameters. Seventy-five patients, 7 to 20 years old with a duration of diabetes of more than 3 years, and 128 age-matched healthy control subjects underwent bilateral studies of median, peroneal, and sural nerves. Presence of diabetes lowered motor conduction velocity (p < 0.0001), sensory conduction velocity (p < 0.0001) and sensory nerve action potential (p < 0.05) in all examined nerves. The mean change in conduction velocity induced by diabetes was -4.8 m/s in the peroneal nerve, -3.3 m/s in the median motor nerve, -2.6 m/s in the sural nerve and -2.4 m/s in the median sensory nerve. Fifty-seven percent of the patients had abnormal conduction (values outside 95% predictive interval) which was seen most often in the motor nerves, especially in the peroneal nerve (41%) followed by the median nerve (24%). In multiple regression analysis, long-term poor metabolic control and increased body length correlated with nerve dysfunction identified in most examined parameters. Three patients had signs or symptoms suggestive of neuropathy. It is concluded that despite modern multiple insulin injection therapy, with reasonably good metabolic control, nerve dysfunction is still common in children and adolescents with insulin-dependent diabetes mellitus. Risk factors are increased height and long-term poor metabolic control.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Blood Glucose / metabolism
  • Body Weight
  • C-Peptide / blood
  • Case-Control Studies
  • Child
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetic Neuropathies / blood
  • Diabetic Neuropathies / diagnosis
  • Diabetic Neuropathies / physiopathology*
  • Female
  • Functional Laterality
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Median Nerve / physiology
  • Median Nerve / physiopathology
  • Motor Neurons / physiology
  • Neural Conduction*
  • Neurons, Afferent / physiology
  • Patient Dropouts
  • Peroneal Nerve / physiology
  • Peroneal Nerve / physiopathology
  • Regression Analysis
  • Sural Nerve / physiology
  • Sural Nerve / physiopathology

Substances

  • Blood Glucose
  • C-Peptide
  • Glycated Hemoglobin A