Evaluation of polyneuropathy and associated risk factors inchildren with type 1 diabetes mellitus

Abstract

Background/aim: Diabetes mellitus (DM) is one of the most common metabolic diseases seen in the world today. Diabetic neuropathy (DN) is a chronic complication of the disease that is rarely reported in children, since it has a relatively longer latency period. Our main objective in this study is to determine the incidence rate of DN in pediatric DM patients and assess the risk factors associated with DN.Materials and methods: Data from 111 patients from January 2011 to May 2014 were reviewed in a retrospective manner. Nerve conduction studies were performed as the gold standard in diagnosis. Results:The incidence rate of symptomatic DN was 13.5% according to our study results. The EMG-diagnosed DN incidence rate was calculated as 22.5%. Following linear regression analysis, positive correlation was found between diabetes duration, diabetic ketoacidosis, and DN presence. Conclusion:Our study results demonstrate the fact that poor metabolic control, especially during early stages of the disease, is a major risk factor for neuropathy development. Planning prospective studies with long-term evaluations on nerve conduction in children with DM will be beneficial for this subject.

Corneal nerve loss in children with type 1 diabetes mellitus without retinopathy or microalbuminuria

“…However, a study of children with type 1 diabetes showed reduced motor and sensory nerve conduction velocities (24%), and at least one neuropathic symptom (60%) or sign (58%) 9 . In another study, symptomatic neuropathy was present in 13.5% of patients, whereas 22.5% of patients had neurophysiological evidence of neuropathy 10 and 18% had impaired vibrotactile sense 11 . Furthermore, in one study, 36% of patients had more than two abnormal autonomic function tests, and 18.8% had severe autonomic neuropathy 12 .…”

Lesions of the nervous system in children with type 1 diabetes mellitus (literature review)

“…Терапия ДН у детей с СД I типа должна включать методы, влияющие на патогенез развития заболевания, а также симптоматическое лечение и профилактику прогрессирования ДН [1,19]. Нарушение обмена глюкозы служит важным фактором развития ДН, в связи с этим основным методом лечения и профилактики заболевания является строгий метаболический контроль с избеганием как гипергликемических, так и гипогликемических состояний [2,21,25].…”

Corneal nerve and nerve conduction abnormalities in children with type 1 diabetes

“…Generally, children and adolescents do not have signs or symptoms of diabetic polyneuropathy 4–6 and screening tools recommended for adults, such as clinical examination and the Semmes‐Weinstein microfilament, are unreliable, especially in children 7,8 . Abnormalities in motor and sensory nerve conduction studies (NSC) have been reported in ~20%–34.5% of children with type 1 diabetes 9–12 . Due to the absence of clinical symptoms and signs, lack of good pediatric normative data, and technical challenges in performing quantitative sensory testing (QST) 12 and other neurophysiological assessments, the diagnosis of early diabetic neuropathy is challenging in children 13 …”

“…7,8 Abnormalities in motor and sensory nerve conduction studies (NSC) have been reported in $20%-34.5% of children with type 1 diabetes. [9][10][11][12] Due to the absence of clinical symptoms and signs, lack of good pediatric normative data, and technical challenges in performing quantitative sensory testing (QST) 12 and other neurophysiological assessments, the diagnosis of early diabetic neuropathy is challenging in children. 13 Although diabetic neuropathy is known to primarily affect large nerve fibers, small fiber impairment is also being observed, especially early during the subclinical phase.…”