Peripheral Neuropathy in Juvenile Diabetes

Abstract

In order to study the incidence of diabetic peripheral neuropathy in children, nerve conduction studies and complete neurological examinations were performed on 107 unselected diabetic children below seventeen._xears of age. Motor conduction velocity of the ulnar, median, and peroneal nerves and sensory "conduction velocity" of the median nerves were measured by electromyographical technics. On the basis of the results of the electrophysiological and neurological examinations, eleven patients were considered to have definite evidence of peripheral nerve disease, twenty-three had equivocal findings, and seventythree had no demonstrable abnormalities. The diabetic children with definite evidence of peripheral neuropathy had a longer duration of diabetes mellitus, a later age at onset of the disease, and were older at the time of examination than those patients without evidence of peripheral nerve disease. Those children with neuropathy were also thought to have poorer control of diabetes than those without neuropathy, but this was difficult to evaluate because of the interrelationship of the control factor with the duration of the disease. Three patients were found to have diabetic angiopathy; one had unequivocal, one equivocal and one no signs of neuropathy. DIABETES 15: 411-18, June, 1966. An overwhelming number of reports have appeared about the clinical picture, classification, and incidence of neuropathy in diabetes mellitus. Most of these papers deal with adults only, or do not state whether or not children were included. The scarcity of reports on peripheral neuropathy in diabetic children would suggest a lower incidence of neuropathy in them than in diabetic adults. However, in a study limited to children below sixteen years of age, Lawrence and Locke, 1 over an eighteen-month period, found thirteen diabetics with evidence of neuropathy. Their material was partly selected and contained several patients who were examined because of symptoms relating to the peripheral nervous system. Gamstorp 2 showed that unselected diabetic children had a lower conduction velocity of peripheral nerves than normal age-matched controls. However, this From the

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

“…This finding is compatible with the findings of Marcus et al (12), Gregersen (13), and Gamstrop et al (16). Diabetic control assessment is arbitrary, regardless of which criteria are used.…”

Subclinical nerve dysfunction in children and adolescents with IDDM

“…Electrophysiological studies of nerve conduction velocity are probably our most sensitive tools to quantify early abnormalities [6][7][8]. Such studies exist in paediatric patients on conventional treatment [9][10][11][12][13][14][15][16][17][18][19][20][21][22] but not in patients on modern multiple insulin injection therapy (MIT). The benefits of using MITwith tight metabolic control on diabetic late complications have been clearly shown [23][24][25][26].…”

Early onset of severe diabetes mellitus-related microvascular complications

“…3,4 Symptomatic peripheral neuropathy is exceptionally rare in children and teens with T1DM. 5 Subclinical neuropathy has been described by using neurophysiological criteria and is associated with longer duration of disease and poor diabetes control. 5,6 Less commonly, transient painful neuropathy has occurred after a large (14.1% to 7%) reduction of the HbA1c, as in our subject.…”

“…5 Subclinical neuropathy has been described by using neurophysiological criteria and is associated with longer duration of disease and poor diabetes control. 5,6 Less commonly, transient painful neuropathy has occurred after a large (14.1% to 7%) reduction of the HbA1c, as in our subject. There are reports of a 32-yearold man with newly diagnosed T1DM and an 18-year-old woman with poorly controlled T1DM of 8-year duration, both of whom had severe peripheral neuropathy after rapid improvement of hyperglycemia with insulin therapy.…”