Steno Diabetes Center Copenhagen, Department of Clinical and Translational Research, Borgmester Ib Juuls Vej 83, DK-2730 Herlev, Denmark.
Steno Diabetes Center Copenhagen, Department of Clinical and Translational Research, Borgmester Ib Juuls Vej 83, DK-2730 Herlev, Denmark; University Hospital Herlev, Department of Pediatrics and Adolescent Medicine, Borgmester Ib Juuls Vej 1, DK-2730 Herlev, Denmark.
J Diabetes Complications. 2024 Nov;38(11):108873. doi: 10.1016/j.jdiacomp.2024.108873. Epub 2024 Sep 17.
To investigate the prevalence of diabetic polyneuropathy (DPN), cardiac autonomic neuropathy (CAN) and sudomotor dysfunction in children and adolescents with type 1 diabetes using bedside modalities. Secondly, to evaluate the co-existence of these types of diabetes neuropathies.
Cross-sectional study including 221 children and adolescents with type 1 diabetes. DPN was assessed by vibration sensation threshold and sural nerve conductance, CAN by cardiac reflex tests and sudomotor function by electrochemical skin conductance.
Median (interquartile range) age was 14.2 (11.9, 16.5) years, diabetes duration 4.8 (2.7, 7.7) years and Hba1c 7.1 (6.6, 7.9) %, (54: 49, 63 mmol/mol). Three had retinopathy; all had normal albuminuria. DPN was present in 40 %, early CAN in 17 %, established CAN in 3 % and sudomotor dysfunction in the feet in 5 %. Of these, 60 % had one type of neuropathy, while 35 % had two types. Only 1 participant manifested all three types of neuropathies.
Bedside modalities demonstrated a high prevalence of neuropathy in children and adolescents with type 1 diabetes, despite good glycemic outcome, short diabetes duration and absence of complications. A lack of co-existing neuropathies was shown, underscoring the need for multiple screening modalities.
使用床边检测方法调查 1 型糖尿病儿童和青少年中糖尿病多发性神经病变（DPN）、心脏自主神经病变（CAN）和出汗功能障碍的流行情况。其次，评估这些类型糖尿病神经病变的共存情况。
横断面研究纳入 221 名 1 型糖尿病儿童和青少年。通过振动感觉阈值和腓肠神经传导检测评估 DPN，通过心脏反射测试评估 CAN，通过电化学皮肤电导检测评估出汗功能。
中位（四分位间距）年龄为 14.2（11.9，16.5）岁，糖尿病病程 4.8（2.7，7.7）年，HbA1c 7.1（6.6，7.9）%（54：49，63mmol/mol）。3 人有视网膜病变；所有人的尿白蛋白正常。40%存在 DPN，17%存在早期 CAN，3%存在晚期 CAN，5%存在足部出汗功能障碍。其中，60%有 1 种神经病变，35%有 2 种神经病变。仅有 1 名参与者表现出所有 3 种神经病变。
尽管血糖控制良好、糖尿病病程短且无并发症，但床边检测方法显示 1 型糖尿病儿童和青少年的神经病变患病率较高。未发现共存神经病变，这突出了需要使用多种筛查方法。
