Highlights
- •91% of children with TID may have electrophysiological abnormalities.
- •18% of children with T1D develop subclinical neuropathy.
- •Most common pattern of neuropathy in children is pure motor type.
- •Body mass index is an important predictor of neuropathy in children.
- •Nerve conduction should be performed to look for nerve dysfunction and progression.
Abstract
Aim
To detect the prevalence of diabetic polyneuropathy (DPN) in children with type 1
diabetes (T1D) and to identify associated the risk factors.
Methods
This cross-sectional study evaluated children aged between 2 and 16y with T1D for
≥2 y. Detailed neurological examination, neuropathy symptom score, and nerve conduction
studies were done in all children to assess nerve dysfunction. Disease-related factors
were evaluated for the prediction of neuropathy.
Results
Sixty-six children (67% boys) were enrolled. The mean age at the time of diagnosis
of T1D was 7.1 ± 2.6 years. The mean duration of diabetes was 4 ± 1.8 years. None
of the patients had neuropathy on clinical examination or on the neuropathy symptom
score. The prevalence of subclinical DPN was 18.2% (n = 12/66). The type of neuropathy
was pure motor (n = 11, 91.6%) and mixed sensorimotor (n = 1, 8.3%). The common peroneal
nerve was most commonly affected (n = 6, 50%), followed by the tibial (n = 4, 33.3%)
nerve. The most common patterns of nerve involvement were mixed axonal and demyelination
(n = 7, 58.3%), followed by axonal (n = 3, 25%) and demyelinating type (n = 2, 16.6%).
Children with subclinical DPN had a significant reduction in velocity of tibial, common
peroneal, median motor, and ulnar motor nerves; delayed latency in common peroneal,
median motor, ulnar motor, and median sensory nerves compared to those without DPN
(p value <0.05). A higher body mass index predicted the development of subclinical
DPN (p value <0.05).
Conclusion
Nearly one-fifth of children with T1D have subclinical neuropathy as early as two
years of the disease. A higher body mass index is significantly associated with DPN.
Electrophysiological studies should be performed regularly to screen for nerve dysfunction
and its progression.
Keywords
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Article info
Publication history
Published online: January 05, 2022
Accepted:
January 1,
2022
Received in revised form:
December 20,
2021
Received:
August 24,
2021
Identification
Copyright
© 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
