Abstract
Background: Peripheral neuropathy is one of the major microvascular complications of diabetes mellitus. Diabetic peripehral neuropathy is defined as presence of symptoms and / or signs of peripheral nerve dysfunction in diabetic patients after exclusion of other causes. Though incidence of diabetic peripheral neuropathy correlates with duration of diabetes mellitus and degree of hyperglycemia some patients already have neuropathy at time of diagnosis itself.
Objectives: Assessment of nerve conduction abnormalities in patients with newly diagnosed diabetes mellitus.
Materials and Methods: Patients with newly diagnosed diabetes mellitus within one month duration were prospectively recruited. History of symptoms like tingling sensation, hyperaesthesia, burning sensation, history of weakness, gait abnormality and foot ulcer were noted. Complete clinical examination was done. Nerve conduction studies was performed in upper limb and lower limb of non-dominant hand side using a neuro space S1 machine.
Results: Twenty patients [12 men and 8 women] were included in this study with duration of diabetes mellitus <1 month. The mean age of the patients was found to be 58.76 ± 13.6 years. Among these 15 patients [75%] had abnormal nerve conduction studies and 5 patients [25%] were normal. Distal motor latencies were significantly higher in diabetics and also F-wave latencies were prolonged in both upper limb and lower limbs. Sensory conduction velocities decreased in diabetics compared to controls.
Conclusion: Patients with newly diagnosed diabetes mellitus have higher incidence of peripheral neuropathy. So performing nerve conduction studies is highly essential for early detection of diabetic peripheral neuropathy and proper management.
Keywords: NCS (Nerve conduction studies), Newly diagnosed diabetes mellitus, Diabetic peripheral neuropathy, F-waves., HbA1C-Glyosated haemoglobin level.
References
- Leon BM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6(13): 1246–58.
- Harris MI. Undiagnosed NIDDM: Clinical and Public Health Issues. Diabetes Care. 1993 Apr;16(4):642–52.
- Kostev K, Jockwig A, Hallwachs A, Rathmann W. Prevalence and risk factors of neuropathy in newly diagnosed type 2 diabetes in primary care practices: a retrospective database analysis in Germany and U.K. Prim Care Diabetes. 2014 Oct;8(3):250–5.
- Zaharia OP, Strassburger K, Strom A, Bönhof GJ, Karusheva Y, Antoniou S, et al. Risk of diabetes-associated diseases in subgroups of patients with recent-onset diabetes: a 5-year follow-up study. Lancet Diabetes Endocrinol. 2019 Sep;7(9): 684–94.
- Kostev K, Rathmann W. Diabetic retinopathy at diagnosis of type 2 diabetes in the UK: a database analysis. Diabetologia. 2013 Jan;56(1):109–11.
- Pradeepa R, Rema M, Vignesh J, Deepa M, Deepa R, Mohan V. Prevalence and risk factors for diabetic neuropathy in an urban south Indian population: the Chennai Urban Rural Epidemiology Study (CURES-55). Diabet Med. 2008 Apr;25(4):407–12.
- Paul UK, Sinharay K, Bhattacharyya AK, Pal SK. Update in diabetic neuropathy with special reference to Indian scenario. J Indian Med Assoc. 2012 Sep;110(9):616–22.
- Agarwal S, Lukhmana S, Kahlon N, Malik P, Nandini H. Nerve conduction study in neurologically asymptomatic diabetic patients and correlation with glycosylated hemoglobin and duration of diabetes. Natl J Physiol Pharm Pharmacol. 2018;8(9):1533.
- de Souza RJ, de Souza A, Nagvekar MD. Nerve conduction studies in diabetics presymptomatic and symptomatic for diabetic polyneuropathy. J Diabetes Complications. 2015 Aug;29(6):811–7.
- Rota E, Quadri R, Fanti E, Isoardo G, Poglio F, Tavella A, et al. Electrophysiological findings of peripheral neuropathy in newly diagnosed type II diabetes mellitus. J Peripher Nerv Syst. 2005 Dec;10(4):348–53.
- Singh RB, Chandel K, Kumar S. Nerve conduction study findings of subclinical diabetic neuropathy in newly diagnosed diabetic patients. Indian J Neurosci. 2015;1(1):1–7.
- Yadav S, Ramesh V, Bhatia E, Gill H. A prospective study of prevalence and association of peripheral neuropathy in Indian patients with newly diagnosed type 2 diabetes mellitus. J Postgrad Med. 2014;60(3):270.
- Vinik AI. CLINICAL PRACTICE. Diabetic Sensory and Motor Neuropathy. Solomon CG, editor. N Engl J Med. 2016 Apr;374(15):1455–64.
- Pan H, Jian F, Lin J, Chen N, Zhang C, Zhang Z, et al. F-wave latencies in patients with diabetes mellitus. Muscle Nerve. 2014 Jun;49(6):804–8.
Corresponding Author
Dr Nallathambi
Post Graduate, Department of General Medicine, Rajah Muthiah Medical College and Hospital, Chidambaram
DOI: https://dx.doi.org/10.18535/jmscr/v9i3.28
