Electrophysiological characteristics of subclinical diabetic neuropathy in adolescents with type 1 diabetes

초록

Background and aims: Early detection of diabetic polyneuropathy (DPN) is essential in type 1 diabetes mellitus (T1DM), but its electrophysiological features in the subclinical stage are less understood than in type 2 diabetes mellitus (T2DM). Methods: We retrospectively reviewed patients aged 10–19 years with T1DM who underwent DPN screening via NCSs from January 2022 to February 2024. Those with hereditary or pre-existing polyneuropathy, related risk factors, or sensory/motor symptoms were excluded. Motor and sensory NCSs were conducted on major upper and lower limb nerves. DPN was diagnosed if ≥2 independent NCS parameters were abnormal. Results: A total of 107 patients (mean age 17.02 years; range 10.5–19.3; 51 males, 56 females) were included. Among them, 56 were diagnosed with DPN, and 51 were not. There were no significant differences in mean age (17.51 vs. 16.12 years, p = 0.648) or diabetes duration (8.47 vs. 6.98 years, p = 0.176) between groups. All DPN patients showed prolonged ulnar nerve terminal latency, followed by reduced MCV in the distal ulnar nerve (36.7 %) and posterior tibial nerve (27.9 %). Other frequent findings included reduced sensory conduction velocity and SNAP amplitudes in the superficial peroneal and sural nerves, decreased MCV in the peroneal and posterior tibial nerves, and prolonged median nerve TL. No abnormal NCS findings were noted in the non-DPN group. Conclusions: These findings suggest that subclinical DPN in T1DM may show distinct electrophysiological patterns from those of overt DPN in both T1DM and T2DM. Further studies are needed to clarify the characteristics of subclinical DPN in T1DM.