Single-fiber electromyography is a sensitive indicator of axonal degeneration in diabetes

Axonal degeneration with reinnervation was assessed in diabetic subjects with single-fiber electromyography (SF-EMG). SF-EMG was performed on 18 control subjects, 20 diabetic control subjects without clinical or electromyographic evidence of polyneuropathy, and 30 diabetic subjects with clinical and electromyographic features of polyneuropathy. In the diabetic controls and diabetic neuropathy subjects, fiber density and jitter were increased indicating axonal degeneration with reinnervation. These findings confirm that axonal degeneration is a principal pathologic mechanism in diabetic polyneuropathy and that axonal degeneration commonly occurs in asymptomatic diabetic subjects. SF-EMG is thus a sensitive method for assessing axonal degeneration in diabetic subjects.