Visual-evoked potentials in children and adolescents with newly diagnosed diabetes

Abstract

Aim: Central nervous system impairment is common in patients with diabetes, even in the early stages of the disease. The aim of the study was to evaluate central nerve conduction changes in children and adolescents with newly diagnosed diabetes mellitus using pattern-reversal visual-evoked potentials. Material and Methods: Pattern-reversal visual-evoked potentials were assessed in 48 patients with type 1 (age 11.9±2.9 years) and 18 patients with type 2 (age 14.8±1.3 years) diabetes less than a month after diagnosis and in 33 control subjects (age 12.9±3.9 years). Results: P100 latencies were significantly delayed in patients with type 1 and 2 diabetes compared with control subjects (p<0.001). There was no correlation between P100 latencies and age at diagnosis. No correlations were found between P100 latencies and HbA1c values in patients with type 1 diabetes. However, P100 latencies were significantly associated with levels of HbA1c in patients with type 2 diabetes (p<0.01). There was a marked inter-individual variability in amplitudes of N75 to P100 in both patients with diabetes and controls. The amplitudes of N75 to P100 were not associated with levels of HbA1c in patients with diabetes. Negative correlations between amplitudes of N75 to P100 and age at diagnosis were noted in patients with type 1 diabetes (p<0.05). Conclusions:The impaired visual-evoked potential latencies in children and adolescents with newly diagnosed diabetes mellitus suggest an early involvement of the optic pathway. Visual-evoked potential could be helpful for the early detection of central nerve conduction changes at this subclinical stage of the disease.

The Evaluation of Pattern-Reversal Visual Evoked Potentials in Children with Type 1 Diabetes Mellitus

“…The prolongation of the latency of VEP may not depend solely on the fact that DM is a long-standing disease. Because in previous studies compared to control patients of new diagnosed T1DM patients latency of P100 potentials was found to be prolonged (5,6,12,16,(21)(22)(23)(24)(25). Deterioration of VEP latency in newly diagnosed T1DM children indicates that the optic pathway is affected early.…”

“…This shows that newly diagnosed T1DM cases do not have impaired macular functions. With these supportive findings, VEP can be assessed at baseline at the time of T1DM diagnosis and reapplied at specific intervals to assess the CNS impairment during the course of disease (22). As ours was a cross-sectional study, VEP was performed in cases of T1DM diagnosed at least one year previously, so no newly diagnosed T1DM cases were included.…”

Tip 1 Diabetes Mellituslu Çocuklarda Uyarılmış Potansiyellerin Eş Zamanlı Kan Şekeri, Serum ve Hücre İçi Magnezyum Düzeyleri ve Glikozillenmiş Hemoglobin İle İlişkisi

“…nöropatinin patogenezindeki mekanizmalar tam olarak çözümlenmiş olmasa da polyol yolu, non enzimatik glokolizasyon, myoinozitol metabolizması bozuklukları gibi metabolik faktörler, vasküler anormallikler suçlanmaktadır (3,12). Diabette sadece periferik değil santral sinir sistemi de tutulmaktadır (5). Diabetik hastalarda nöropati subjektif semptomlar ve geçici bulgularla çoğu zaman yıllar sonra ortaya çıkar.…”

“…Klinik olarak normal olan bireylerde santral sinir sistemi tutulumu en erken bulgu olabilir. Bunu saptamak amacıyla uyarılmış potansiyel ölçümleri yapılmaktadır (5,6).…”

“…Bu ölçümlerde, periferik nöropatisi olan hastalarda santral sinir sistemini bozukluklarına daha sık rastlanmasına rağmen, nöropatisi olmayan hastalarda da uyarılmış potansiyellerin bozulabileceği gösterilmiştir. Glikozillenmiş hemoglobin (HbA1c) düzeylerinin diabetin kronik komplikasyonları ile ilişkisi bilinirken, uyarılmış potansiyeller ile olan ilişkisi halen araştırmaktadır (5)(6)(7).…”