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Relation between limited joint mobility and peripheral nerve function in diabetic children
C Fiçicioğlu1, M Kiziltan, A Aydin
1Department of Pediatrics, Istanbul University Cerrahpaşa Faculty of Medicine, Istanbul.
Insights
Limited joint mobility (LJM) is common in diabetic children and linked to poorer nerve function. Early detection of LJM can motivate better diabetes control to prevent neuropathy.
Area of Science:
- Pediatrics
- Neurology
- Endocrinology
Background:
- Diabetic neuropathy is a common complication in children.
- Limited joint mobility (LJM) has been observed in diabetic patients, but its association with peripheral nerve function requires further investigation.
Purpose of the Study:
- To investigate the relationship between limited joint mobility (LJM) and peripheral nerve function in children with diabetes.
- To determine if LJM can serve as an early indicator for diabetic neuropathy risk.
Main Methods:
- Electromyography (EMG) was used to measure peroneal and sural nerve function in 60 diabetic children and 31 healthy controls.
- Limited joint mobility was assessed using the 'prayer sign' hand position.
- Factors influencing LJM, including age, diabetes duration, and metabolic control (HbA1c), were analyzed.
Main Results:
- 38.3% of diabetic children exhibited limited joint mobility.
- LJM was significantly influenced by age, duration of diabetes, and HbA1c levels (p < 0.001).
- Diabetic children with LJM showed significantly impaired nerve conduction (amplitude, velocity, latency) compared to controls (p < 0.01).
Conclusions:
- Limited joint mobility is a prevalent finding in diabetic children and is associated with compromised peripheral nerve function.
- LJM serves as a sensitive indicator for identifying children at risk of developing diabetic neuropathy.
- LJM assessment can motivate improved glycemic control to prevent or delay neuropathy progression.
Abstract:
In order to assess the relation between limited joint mobility (LJM) and peripheral nerve function in diabetic children, peroneal nerve amplitude and motor conduction velocity as well as sural nerve amplitude and distal latency were measured with a Medelec MSG electromyograph. LJM was examined by observing the hands in the prayer position of 60 unselected diabetic children (average age 11.2 +/- 3.1 years; mean duration of diabetes 4.1 +/- 3 years) and 31 healthy controls. Of 60 patients, 38.3 percent had limited joint mobility. no influence of sex on expression of LJM was found. Its appearance was influenced by age, duration of diabetes and metabolic control (HbA1c) (p < 0.001, p < 0.001, p < 0.001, respectively). The mean amplitude, nerve conduction velocity and distal latency values in diabetic children with LJM were slower than those in the normal control group (peroneal amplitude p < 0.01), peroneal MCV p < 0.001, sural amplitude p < 0.001, sural distal latency p < 0.001). Of four patients with stage IV LJM, three had symptomatic neuropathy diagnosed using the criteria suggested by Dyck. Consequently, LJM identifies a population at risk for development of diabetic neuropathy. Thus, being easy and sensitive, LJM determination may provide both the physician and the patient himself with an important motivation to improve diabetic control in an effort to prevent diabetic neuropathy.