Subclinical Neuropathy in Children With Type I Diabetes Mellitus: Tertiary Care Centre Experience

Abstract

Introduction: Diabetic peripheral neuropathy is a common complication of diabetes mellitus (DM) type 1. However, it can occur without evidence of symptoms or clinical signs of neuropathy labeled as subclinical neuropathy, which neurophysiological studies can best detect. Purpose: To evaluate the prevalence of subclinical neuropathy among children with DM type 1, determine the association with blood sugar control, and evaluate the pattern of nerve involvement in neurophysiological studies. Methods: This cross-sectional study evaluated 100 children with DM type 1, aged five to 15 years, at least one year after the diagnosis. Subclinical neuropathy was evaluated using nerve conduction study. Glycemic control was assessed using hemoglobin A1c (HbA1c). Results: The mean age of subjects was 11.5 ± 0.25 years. The average age at the onset of the disease was 5.95 ± 0.25 years. There were 64 patients who had electrophysiological evidence of peripheral neuropathy. The most observed electrophysiological changes were distal latency abnormalities in the left and right peroneal nerves in 39 and 33 patients, respectively. Sensory nerve amplitude, peak latency, and conduction velocity were normal in all patients (100%). HbA1c level did not show a statistically significant association with the incidence of subclinical neuropathy. Conclusion: Subclinical neuropathy was prevalent in children with DM type 1. Poor glucose control was only associated with an increased odds ratio of subclinical neuropathy.

Subclinical peripheral neuropathy is common in neuronal intranuclear inclusion disease with dominant encephalopathy

“…No clear complaints or obvious signs of peripheral neuropathy could be easily noticed in most patients [20]. However, it is worth further exploring whether these patients have subclinical peripheral neuropathy, also known as asymptomatic peripheral neuropathy, defined as no clinical symptoms and signs of neuropathy but positive electrodiagnostic tests [21]. In this study, the aim was to investigate the detailed electrophysiological and pathological changes in a series of NIID patients who show dominant CNS involvement and no clinical symptoms of peripheral neuropathy.…”