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Subclinical nerve dysfunction in children and adolescents with IDDM
L Hyllienmark1, T Brismar, J Ludvigsson
1Department of Clinical Neurophysiology, University Hospital of Linköping, Sweden.
Diabetologia
|June 1, 1995
Summary
Even with modern insulin therapy, young patients with insulin-dependent diabetes mellitus often develop peripheral nerve dysfunction. Long-term poor metabolic control and increased height are key risk factors for this nerve damage.
Area of Science:
- Neurology
- Endocrinology
- Diabetology
Background:
- Peripheral nerve dysfunction is a known complication of diabetes mellitus.
- The impact of modern multiple insulin injection therapy on nerve health in young patients remains an area of investigation.
Purpose of the Study:
- To determine if young patients with insulin-dependent diabetes mellitus (IDDM) develop peripheral nerve dysfunction despite modern insulin therapy.
- To identify correlations between nerve dysfunction and specific disease parameters in this population.
Main Methods:
- Nerve conduction studies (motor and sensory) were performed on median, peroneal, and sural nerves in 75 diabetic patients (ages 7-20) and 128 healthy controls.
- Multiple regression analysis was used to assess correlations between nerve function and clinical parameters.
Main Results:
- Diabetic patients exhibited significantly lower motor and sensory nerve conduction velocities and sensory nerve action potentials compared to controls.
- Abnormal nerve conduction was observed in 57% of patients, most frequently in motor nerves (peroneal and median).
- Long-term poor metabolic control (HbA1c) and increased body length were significantly correlated with nerve dysfunction.
Conclusions:
- Peripheral nerve dysfunction is common in young patients with IDDM, even with contemporary insulin injection regimens.
- Increased height and sustained poor metabolic control are identified as significant risk factors for developing nerve damage in this age group.