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Abstract
Background:
Early detection of neuropathy may prevent further progression of this complication in the diabetic patients. The purpose of this study was to evaluate the prevalence of early neuropathic complication in patients with newly diagnosed type 1 and type 2 diabetes.
Methods:
Nerve conduction studies (median, ulnar, posterior tibial, peroneal, and sural nerves) were performed for 49 type 1 (27 males, mean 14.1±7.5 years) and 40 type 2 (27 males, 42.0±14.1 years) diabetic patients at onset of diabetes. Children with age at onset under 4 years and adults over 55 years were excluded to eliminate the aging effect and the influence of obstructive arteriosclerosis. Neuropathy was defined as abnormal nerve conduction findings in two or more nerves including the sural nerve.
Results:
Mean HbA1c level was 12.6±3.3% for type 1 and 10.5±2.9% for type 2 diabetes. The prevalence of neuropathy was 12.2% for type 1, and 35.0% for type 2 diabetes, respectively. There were significant trends in the prevalence of neuropathy with increasing age (p<0.05). The effect of the mean level of glycosylated hemoglobin on the prevalence of polyneuropathy at onset of diabetes was borderline (p=0.0532). Neither sex of the patients nor the type of diabetes affected the neurophysiologic abnormalities at the diagnosis.
Conclusions:
Even in a population with diabetes at the diagnosis, the prevalence of subclinical neuropathy was not low. Neuropathy has been significantly associated with increasing age indicating the possibility of longer duration of undetected diabetes among them, especially in type 2 diabetes. (Korean J Clin Neurophysiol 2014;16:8-14)
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Table 1.
Proportion of patients showing altered nerves in NCS at the diagnosis of diabetes mellitus
| No. of nerves altered | Type 1 DM (n=49, %) | Type 2 DM (n=40, %) |
|---|---|---|
| 1 | 13 (26.5) | 6 (15.0) |
| 2 | 8 (16.3) | 14 (35.0) |
| 3 | 9 (18.4) | 7 (17.5) |
| 4 | 2 (4.1) | 7 (17.5) |
| 5 | 1 (2.0) | 2 (5.0) |
Table 2.
Percentage of patients showing each single nerve altered at the diagnosis of diabetes mellitus
Table 3.
Proportion of patients showing altered parameters of nerve conduction study at the diagnosis of diabetes mellitus
| No. of parameters* altered | Type 1 DM (n=49, %) | Type 2 DM (n=40, %) |
|---|---|---|
| 1 | 11 (22.4) | 4 (10.0) |
| 2 | 6 (12.2) | 8 (20.0) |
| 3 | 5 (10.2) | 7 (17.5) |
| 4 | 4 (8.2) | 4 (15.0) |
| 5 | 2 (4.1) | 6 (15.0) |
| 6 | 2 (4.1) | 0 |
| 7 | 2 (4.1) | 1 (2.5) |
| 8 | 1 (2.0) | 1 (2.5) |
| 9 | 0 | 0 |
| 10 | 0 | 2 (5.0) |
| 11 | 0 | 0 |
| 12 | 0 | 0 |
| 13 | 0 | 2 (5.0) |
Table 4.
Relative number of patients with pathological values (mean±2.5 SD) at the diagnosis of diabetes mellitus. Normal limit is given in the parenthesis
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