Electroneurographic profiles of peripheral neuropathy in diabetic patients in Lubumbashi

Electroneurography (ENG) provides an objective tool for assessing nerve function and characterizing electrophysiological profiles. The underutilization of ENG in our setting limits the early diagnosis of peripheral neuropathy (PN), a frequent complication of type 2 diabetes. This study aimed to describe electroneurographic parameters in diabetic subjects (DS) in relation to neuropathic pain (NP) and to compare them with non-diabetic controls (NDS) in Lubumbashi, in order to identify abnormalities specifically attributable to diabetes.

A cross-sectional study included 51 participants (mean age 49.7 ± 11.8 years): 25 DS and 26 NDS. NP was assessed using the validated DN4 questionnaire. ENG recordings were performed with a Neuro-MEP Micro device, following standard protocols for sensory and motor nerve exploration.

NP was significantly more frequent in DS (68%) than in NDS (46%), with a peak in insulin-dependent DS (90%; p < 0.05). All ENG parameters-amplitude, distal latency, and conduction velocity-were significantly altered in DS (p < 0.05), indicating a predominantly axonal, sensory-motor polyneuropathy with demyelinating features, mainly affecting the lower limbs. Patient-level analysis showed that diabetic patients with abnormal ENG had longer diabetes duration (p = 0.04), higher HbA1c (p = 0.02), and more frequent NP (p = 0.03). ENG abnormalities not associated with NP were observed, suggesting subclinical neuropathies.

Combining ENG with the DN4 score facilitates the characterization of diabetic peripheral neuropathy (DPN) and enables the detection of subclinical involvement. Integrating ENG into routine clinical practice in Lubumbashi is essential for early diagnosis. Further studies are needed to establish local normative values and refine electroneurographic profiles.