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Diabetic neuropathy in children
1Division of Pediatric Neurology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Insights
Diabetic neuropathy affects many children with diabetes, with subclinical forms common even at diagnosis. Early detection and new treatments are needed for pediatric diabetic neuropathy.
Area of Science:
- Pediatric Endocrinology
- Neurology
- Metabolic Disorders
Background:
- Global diabetes rates, including type 1 and type 2, are rising in children.
- Diabetic neuropathy, a serious complication, is increasingly prevalent in pediatric populations.
- Subclinical neuropathy affects up to 50% of children with type 1 diabetes exceeding 5 years and 25% of newly diagnosed cases.
Purpose of the Study:
- To review the current understanding of pediatric diabetic neuropathy.
- To cover its definition, prevalence, pathogenesis, diagnosis, risk factors, and treatments.
- To highlight knowledge gaps and future research directions in this field.
Main Methods:
- Literature review of existing studies on pediatric diabetic neuropathy.
- Analysis of prevalence data and diagnostic findings in children and adolescents.
- Synthesis of current knowledge on pathogenesis and risk factors.
Main Results:
- Subclinical diabetic neuropathy is common in children with diabetes.
- Abnormal nerve conduction studies are found in a significant percentage of pediatric patients.
- The review synthesizes current data on the multifaceted aspects of pediatric diabetic neuropathy.
Conclusions:
- Pediatric diabetic neuropathy is a significant concern requiring further investigation.
- Current screening recommendations emphasize clinical assessment due to lack of specific pediatric interventions.
- Development of rapid, quantifiable diagnostic tests and pediatric norms is crucial for future management.
Abstract:
The worldwide burden of diabetes and its complications in children continues to increase due to the rise in type 1 and type 2 diabetes. Although overt diabetic neuropathy is rarely present in children and adolescents with diabetes, subclinical diabetic neuropathy has been estimated to occur in approximately half of all children with type 1 diabetes with a duration of 5 years or longer and up to 25% of pediatric patients with newly diagnosed diabetes have abnormal findings on nerve conduction studies. The present review on the state of pediatric diabetic neuropathy covers the definition, prevalence, pathogenesis, diagnosis, risk factors, and possible treatment approaches specific to children and adolescents with diabetes. It also highlights the many unknowns in this field. Nonetheless, new emerging interventions that can either prevent or delay the progression of diabetic microvascular and macrovascular complications may become available in the near future. Until specific interventions for diabetic neuropathy are available for use in children, it will be hard to justify screening for neuropathy other than through clinical assessment. Meanwhile, the search for quicker, easily administered, and quantifiable tests for diabetic neuropathy and efforts to establish valid pediatric norms for well-established measures used in adults will need to continue.
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