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Evidence for diabetic encephalopathy.

A Dejgaard1, A Gade, H Larsson

  • 1Hvidøre Hospital, Klampenborg, Denmark.

Diabetic Medicine : a Journal of the British Diabetic Association
|February 1, 1991
PubMed
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Long-duration Type 1 diabetes patients with complications show abnormal auditory brain stem responses and brain lesions, indicating subclinical central nervous system affection, termed diabetic encephalopathy.

Area of Science:

  • Neurology
  • Endocrinology
  • Diabetology

Background:

  • Type 1 diabetes mellitus (T1DM) is a chronic condition associated with microvascular and macrovascular complications.
  • Peripheral neuropathy and retinopathy are common microvascular complications in T1DM.
  • The impact of long-standing T1DM on the central nervous system (CNS) remains an area of active investigation.

Purpose of the Study:

  • To investigate subclinical central nervous system affection in Type 1 diabetic patients.
  • To assess auditory brain stem responses (ABRs) and brain magnetic resonance imaging (MRI) findings in long-duration T1DM patients with complications.
  • To evaluate cognitive function in long-duration T1DM patients.

Main Methods:

  • Auditory brain stem responses (ABRs) were recorded in 20 long-duration T1DM patients (with neuropathy/retinopathy) and 19 short-duration T1DM patients (without complications).

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  • Brain MRI was performed on 16 long-duration T1DM patients and 40 healthy controls.
  • Neuropsychological testing, including 17 intelligence and cognition tests, was conducted on the long-duration T1DM group.

    • Main Results:

    • Abnormal ABRs were observed in 40% of long-duration T1DM patients versus 5.3% in short-duration T1DM patients (p<0.01).
    • Significantly prolonged interpeak latencies (Jv-JI, JIII-JI) were found in both T1DM groups compared to controls (p<0.01).
    • Brain MRI revealed subcortical and/or brain stem lesions in 69% of long-duration T1DM patients compared to 12% of controls (p<0.02).
    • Neuropsychological tests showed cognitive performance comparable to age-matched healthy controls.

    Conclusions:

    • Long-duration Type 1 diabetic patients with retinopathy and peripheral neuropathy exhibit a high prevalence of subclinical central nervous system involvement.
    • These findings suggest the presence of diabetic encephalopathy, characterized by objective neurological signs (ABRs, MRI lesions) despite the absence of overt neurological symptoms.
    • Early detection and management of CNS complications in T1DM may be crucial.