Evaluating peripheral nerve function in asymptomatic patients with type 2 diabetes or latent autoimmune diabetes of adults (LADA): results from nerve conduction studies

Wang, Congrong; Lu, Jingyi; Lü, Wei; Yu, Hong; Jiang, Lan; Li, Ming; Chen, Haibing; Yu, Haoyong; Zhou, Jian; Liu, Fang; Bao, Yuqian; Jia, Weiping

doi:10.1016/j.jdiacomp.2014.11.001

Cited by 15 publications

(19 citation statements)

References 27 publications

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“…Investigations of diabetic peripheral neuropathy in LADA are limited in number. Studies have reported a similar prevalence of neuropathy between LADA and type 2 diabetes but significantly higher rates in LADA than type 1 diabetes despite a shared autoimmune basis . The findings of the latter studies are consistent with the patterns of change in nerve pathophysiology observed in the current investigation.…”

Section: Discussioncontrasting

confidence: 95%

“…Studies have reported a similar prevalence of neuropathy between LADA and type 2 diabetes but significantly higher rates in LADA than type 1 diabetes despite a shared autoimmune basis. [28][29][30] The findings of the latter studies are consistent with the patterns of change in nerve pathophysiology observed in the current investigation. In keeping with our findings that patients with LADA demonstrated the greatest nerve dysfunction, recent results have also highlighted there is greater small nerve fibre pathology in LADA compared to type 2 diabetes.…”

Section: Discussionsupporting

confidence: 89%

“…In keeping with our findings that patients with LADA demonstrated the greatest nerve dysfunction, recent results have also highlighted there is greater small nerve fibre pathology in LADA compared to type 2 diabetes . No differences in nerve conduction parameters between the LADA and type 2 diabetes groups were observed, which is similar to Wang et al when diabetes duration of the cohorts is considered. Of note, a correlation between nerve structure and function has previously been observed in type 1, but not type 2, diabetes .…”

Section: Discussionmentioning

confidence: 99%

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Altered peripheral nerve structure and function in latent autoimmune diabetes in adults

Issar

Yan

Kwai

et al. 2019

Diabetes Metabolism Res

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Aim The present study was undertaken to investigate mechanisms of peripheral nerve dysfunction in latent autoimmune diabetes in adults (LADA). Materials and methods Participants with LADA (n = 15) underwent median nerve ultrasonography and nerve excitability to examine axonal structure and function, in comparison to cohorts of type 1 diabetes (n = 15), type 2 diabetes (n = 23) and healthy controls (n = 26). The LADA group was matched for diabetes duration, glycaemic control, and neuropathy severity with the type 1 and type 2 diabetes groups. A validated mathematical model of the human axon was utilized to investigate the pathophysiological basis of nerve dysfunction. Results The most severe changes in nerve structure and function were noted in the LADA group. The LADA cohort demonstrated a significant increase in nerve cross‐sectional area compared to type 1 participants and controls. Compared to type 1 and 2 diabetes, measures of threshold electrotonus, which assesses nodal and internodal conductances, were significantly worse in LADA in response to both depolarising currents and hyperpolarising currents. In the recovery cycle, participants with LADA had a significant increase in the relative refractory period. Mathematical modelling of excitability recordings indicated the basis of nerve dysfunction in LADA was different to type 1 and 2 diabetes. Conclusions Participants with LADA exhibited more severe changes in nerve function and different underlying pathophysiological mechanisms compared to participants with type 1 or 2 diabetes. Intensive management of risk factors to delay the progression of neuropathy in LADA may be required.

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Altered peripheral nerve structure and function in latent autoimmune diabetes in adults

Issar

Yan

Kwai

et al. 2019

Diabetes Metabolism Res

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“…However, measures of small fibre structure (intra-epidermal nerve fibre density, corneal nerve fibre density and corneal nerve branch density) were significantly worse in people with LADA compared with participants with Type 2 diabetes. This relatively more advanced pathology of small fibres may explain the discrepant findings in previous studies where participants with LADA have been shown to have either no or mild neuropathy compared with participants with Type 2 diabetes (6,8,20,21). Furthermore, given that corneal confocal microscopy is rapid and non-invasive, it has considerable utility for future longitudinal studies in LADA (23).…”

Section: Discussionmentioning

confidence: 92%

“…In one study, current perception thresholds and electrophysiology were found to be similar in participants with LADA, Type 1 and Type 2 diabetes (20). In a large Chinese study of participants with LADA (n=360), nerve conduction deficits were common (~19%) in those with less than 5 years of diabetes (21). However, the metabolic parameters in these subgroups were not documented and there was no assessment of small nerve fibres.…”

Section: Discussionmentioning

confidence: 99%

Latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy

et al. 2019

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Aim To assess if latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy. Methods Participants with LADA (n=31), Type 2 diabetes (n=31) and healthy control participants without diabetes (n=31) underwent a detailed assessment of neurologic deficits, quantitative sensory testing, electrophysiology, skin biopsy and corneal confocal microscopy. Results The groups were matched for age (healthy control without diabetes: 53.5±9.1 vs. Type 2 diabetes: 58.0±6.5 vs. LADA: 53.2±11.6 years), duration of diabetes (Type 2 diabetes: 10.0±8.3 vs. LADA: 11.0±9.1 years) and blood pressure. However, BMI (P=0.01) and triglycerides (P=0.0008) were lower and HbA1c (P=0.0005), total cholesterol (P=0.01) and HDL (P=0.002) were higher in participants with LADA compared with Type 2 diabetes. Peroneal motor nerve conduction velocity (P=0.04) and sural sensory nerve conduction velocity (P=0.008) were lower in participants with latent autoimmune diabetes in adults compared with Type 2 diabetes. Intra‐epidermal nerve fibre density (P=0.008), corneal nerve fibre density (P=0.003) and corneal nerve branch density (P=0.006) were significantly lower in participants with LADA compared with Type 2 diabetes. There were no significant differences in the other neuropathy parameters. Conclusions Despite comparable age and duration of diabetes, participants with LADA demonstrate more severe neuropathy and particularly small fibre neuropathy, compared with participants with Type 2 diabetes.

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Diabetische Neuropathie – Relevanz metabolischer Phänotypen

Bönhof

Ziegler

2020

Diabetologe

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Evaluating peripheral nerve function in asymptomatic patients with type 2 diabetes or latent autoimmune diabetes of adults (LADA): results from nerve conduction studies

Cited by 15 publications

References 27 publications

Altered peripheral nerve structure and function in latent autoimmune diabetes in adults

Altered peripheral nerve structure and function in latent autoimmune diabetes in adults

Latent autoimmune diabetes of adulthood (LADA) is associated with small fibre neuropathy

Diabetische Neuropathie – Relevanz metabolischer Phänotypen

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