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Peripheral neuropathy in children with type 1 diabetes
M Louraki1, C Karayianni, C Kanaka-Gantenbein
1Diabetic Clinic, Second Department of Paediatrics, University of Athens, P&A Kyriakou Children's Hospital, Athens, Greece. mlouraki@hotmail.com
Diabetes & Metabolism
|April 17, 2012
Summary
Diabetic neuropathy (DN) is a common complication in adolescents with type 1 diabetes mellitus (T1DM). Early detection using screening tools is crucial for preventing nerve damage.
Area of Science:
- Neurology
- Endocrinology
- Diabetology
Background:
- Diabetic neuropathy (DN) is a significant complication of type 1 diabetes mellitus (T1DM), leading to morbidity and mortality in adults.
- While clinical neuropathy is rare in children, subclinical neuropathy is prevalent in adolescents with T1DM.
- Peripheral DN affects large and/or small nerve fibers, impacting quality of life.
Purpose of the Study:
- To highlight the importance of early detection of subclinical diabetic neuropathy in pediatric T1DM patients.
- To discuss diagnostic methods for DN, emphasizing screening tools suitable for adolescents.
- To underscore the role of glycemic control in preventing and managing DN.
Main Methods:
- Nerve conduction studies (NCS) are the gold standard but invasive and primarily detect large-fiber abnormalities.
- Vibration sensation thresholds (VSTs) and thermal discrimination thresholds (TDTs) are practical screening tools for early DN detection.
- Assessment of glycemic control as a key factor in DN development.
Main Results:
- Subclinical neuropathy is common in adolescents with T1DM.
- VSTs and TDTs are effective and accessible screening methods for pediatric populations.
- Poor glycemic control is the primary risk factor for DN progression.
Conclusions:
- Early identification of nervous system abnormalities in children and adolescents with T1DM is critical.
- Maintaining near-normoglycemia is essential for preventing or reversing neural impairment.
- Current treatments for DN primarily manage symptoms, making prevention through early detection and control paramount.
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