Department of Physiology, Faculty of Medicine, University of Khartoum, 11111, Sudan.
Department of Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, 11111, Sudan.
J Diabetes Res. 2019 Jul 2;2019:2435261. doi: 10.1155/2019/2435261. eCollection 2019.
Diabetic peripheral neuropathy (DPN) involves sensory and motor nerves, resulting in demyelination as well as axonal degeneration. This study was conducted to describe the pattern of lower limb nerve involvement in children with type 1 diabetes mellitus (DM) based on the parameters of nerve conduction study (NCS). This cross-sectional study recruited 50 children with type 1 DM having mean disease duration of 4.92 ± 3.84 years who attended the referred clinic in Sudan Childhood Diabetes Center. Their mean age was 15.00 ± 2.19 years, 42% were males, and 58% were females. Twenty six matched healthy control subjects were involved; their mean age was 13.88 ± 2.46 years, 38.46% were males, and 61.54% were females. Bilateral NCS of the sensory and motor lower limb nerves was performed using Medelec Synergy machine. Interpretation of the patients' results was based on our own control reference values. Data was analysed using IBM SPSS statistics. Out of the 50 diabetic patients, 44 (88%) had electrophysiological evidence of peripheral neuropathy (abnormalities in at least two of the electrophysiological parameters). The majority (68.2%) had motor involvement and 31.8% had sensorimotor, while none of them (0%) had pure sensory involvement. Regarding abnormal NCS parameters (conduction velocity vs. amplitude of the compound action potential), conduction slowing feature predominated in 61.4% and only few (6.8%) showed amplitude reduction, while 31.8% showed mixed features. The most frequently affected nerve was the common peroneal, followed by posterior tibial, and the least was the sural nerve. The most sensitive parameter was the common peroneal conduction velocity. Motor precedes sensory nerve involvement. The most frequent neurophysiological abnormality was the conduction slowing, and the common peroneal was the most vulnerable nerve. These findings signify generation of a protocol for early screening of neuropathy in children with type 1 diabetes.
糖尿病周围神经病变（DPN）涉及感觉和运动神经，导致脱髓鞘和轴突变性。本研究旨在描述基于神经传导研究（NCS）参数的 1 型糖尿病（DM）患儿下肢神经受累模式。这项横断面研究招募了 50 名患有 1 型 DM 的儿童，平均病程为 4.92±3.84 年，他们在苏丹儿童糖尿病中心的转诊诊所就诊。他们的平均年龄为 15.00±2.19 岁，42%为男性，58%为女性。共有 26 名匹配的健康对照组参与，平均年龄为 13.88±2.46 岁，38.46%为男性，61.54%为女性。使用 Medelec Synergy 机器对双侧感觉和运动下肢神经进行 NCS。患者结果的解释基于我们自己的对照参考值。使用 IBM SPSS 统计数据进行数据分析。在 50 名糖尿病患者中，44 名（88%）有周围神经病变的电生理证据（至少有两个电生理参数异常）。大多数（68.2%）有运动受累，31.8%有感觉运动受累，而他们中没有一个人（0%）有单纯感觉受累。关于异常 NCS 参数（传导速度与复合动作电位的幅度），传导速度减慢特征占 61.4%，只有少数（6.8%）显示幅度降低，而 31.8%显示混合特征。受影响最频繁的神经是常见的腓神经，其次是后胫神经，最不常见的是腓肠神经。最敏感的参数是常见的腓神经传导速度。运动先于感觉神经受累。最常见的神经生理异常是传导速度减慢，常见的腓神经是最脆弱的神经。这些发现表明为 1 型糖尿病儿童制定了早期筛查神经病变的方案。
