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Studies on central nervous system function in diabetes mellitus.

T Das1, S Kundu, A K Mazumdar

  • 1Department of Medicine, Medical College, Calcutta.

Journal of the Indian Medical Association
|August 3, 2001
PubMed
Summary

Subclinical central nervous system (CNS) dysfunction is prevalent in diabetes mellitus, especially in non-insulin dependent diabetes mellitus (NIDDM). Neurophysiological tests like visual evoked potential (VEP) reliably detect these early changes.

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Area of Science:

  • Neurology
  • Endocrinology
  • Diabetology

Background:

  • Diabetes mellitus is a systemic disease with potential neurological complications.
  • Subclinical central nervous system (CNS) involvement is suspected in diabetic patients.
  • Early detection of CNS dysfunction is crucial for timely intervention.

Purpose of the Study:

  • To investigate subclinical CNS dysfunction in patients with insulin dependent (IDDM) and non-insulin dependent diabetes mellitus (NIDDM).
  • To compare neurophysiological test results between diabetic subtypes and healthy controls.
  • To assess the utility of evoked potentials in detecting early CNS changes in diabetes.

Main Methods:

  • Studied 57 diabetic patients (IDDM and NIDDM) and 25 controls, excluding those with known neurological or severe diabetic complications.

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  • Performed clinical CNS examination and brain CT scans, which were normal in all participants.
  • Conducted neurophysiological tests: visual evoked potential (VEP), brainstem auditory evoked response (BAER), and somatosensory evoked potential (SEP).

    • Main Results:

    • Significantly prolonged mean VEP latencies were observed in both IDDM and NIDDM groups compared to controls.
    • Mean BAER and SEP latencies were significantly elevated in NIDDM patients but not in IDDM patients.
    • Abnormal CNS latencies were detected in 16.7% (VEP), 50% (BAER), and 26.7% (SEP) of NIDDM cases, and 11.1% (VEP), 14.8% (BAER), and 18.5% (SEP) of IDDM cases.

    Conclusions:

    • Subclinical CNS dysfunction is common in diabetes mellitus, particularly in NIDDM.
    • Neurophysiological tests, especially VEP, reliably detect these early neurological alterations.
    • Evoked potential measurements offer a valuable tool for assessing CNS involvement in diabetic patients.