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Autonomic and peripheral nerve function in adolescents with and without diabetes
K C Donaghue1, M Bonney, J M Simpson
1Ray Williams Institute of Paediatric Endocrinology, Royal Alexandra Hospital for Children, Sydney, Australia.
Summary
Reference ranges for nerve function tests were established in adolescents. Age and gender significantly impact autonomic and peripheral nerve test results, with diabetes showing a link to autonomic abnormalities but not peripheral ones.
Area of Science:
- Neurology
- Adolescent Medicine
- Diabetology
Background:
- Establishing normative data for neurological function in adolescents is crucial for identifying abnormalities.
- Autonomic and peripheral nerve functions can be influenced by physiological factors like age and gender.
- Diabetic neuropathy is a common complication, necessitating understanding of reference ranges in this population.
Purpose of the Study:
- To establish reference ranges for autonomic and peripheral nerve tests in non-diabetic adolescents.
- To investigate the influence of age and gender on these neurological parameters.
- To compare neurological test results in adolescents with diabetes to established reference ranges and explore associations with glycemic control.
Main Methods:
- Reference ranges were determined using the REFVAL programme for 122 non-diabetic adolescents.
- Regression analysis assessed the impact of age and gender on nerve function tests.
- Autonomic and peripheral nerve tests were administered to 181 adolescents with diabetes under identical conditions.
Main Results:
- Increasing age correlated with reduced heart rate variability and elevated thermal/vibration thresholds.
- Male gender was associated with higher Valsalva ratio, thermal thresholds, and vibration thresholds.
- Adolescents with diabetes showed a higher prevalence of abnormal autonomic tests (28%) than expected (18.5%), with glycemic control linked to autonomic, but not peripheral, abnormalities.
Conclusions:
- Age and gender are significant determinants of autonomic and peripheral nerve function in adolescents.
- While diabetes is associated with autonomic dysfunction, glycemic control and diabetes duration did not show a significant impact on neurological function after adjusting for age and gender.
- These established reference ranges are vital for accurate diagnosis and management of neurological complications in adolescents, particularly those with diabetes.