ESPE Abstracts (2022) 95 RFC8.3

ESPE2022 Rapid Free Communications Diabetes and Insulin (6 abstracts)

Peripheral nerve conduction velocity in children and young adults with type 1 diabetes mellitus as a marker of metabolic control

Sarah Oberhauser 1 , Dagmar l'Allemand 1 , Katrin Heldt 1 , Tiziana Gozzi 1 , Aikaterini Stasinaki 1 , Miriam Eilers 1 , Jürg Lütschg 2,3 & Philip Broser 2,3

1Paediatric endocrinology and diabetology, Children’s Hospital of Eastern Switzerland, Sankt Gallen, Switzerland; 2Paediatric neurology, Children’s Hospital of Eastern Switzerland, Sankt Gallen, Switzerland; 3Medical Faculty, University of Basel, Basel, Switzerland

Background: Nerve conduction velocity (NCV) abnormalities are considered as early signs of peripheral neuropathy in patients with diabetes mellitus (DM). We investigated which determinants NCV is subject to and how it is related to markers of metabolic control.

Methods: We included 51 patients treated at the outpatient clinic of paediatric diabetology because of their type 1 DM and randomly assigned them for a nerve conduction study (NCS) at the occasion of their annual check-up. During this check-up a whole clinical examination, measurement of HbA1c and analysis of the last 90 days glucose profile with the characteristics time in range, incidence of hyperglycaemia (>10 mmol/l) and serious hypoglycaemia (<3 mmol/l), variation of the average blood glucose was done. Besides, we checked for drug abuse, associated autoimmune diseases (thyroiditis, coeliac disease), complications of DM (nephropathy, retinopathy) and comorbidities (dyslipidaemia, vitamin D insufficiency). To characterize the study group well we registered the age, duration of DM with its type depending on diabetes antibodies or MODY. An impression about the long term metabolic control was obtained by the mean HbA1c values of the last five annual check-ups, the incidence of severe hypoglycaemia and ketoacidosis since onset of DM, the kind of therapy (conventional or functional basal-bolus regimen, continuous subcutaneous insulin infusion (CSII)) and monitoring (blood glucose meter, sensor). The associations of NCV with physical findings, markers for diabetes control and known risk factors for neuropathy were tested by the analysis of Kendal-Tau with a significance level of 5 %, which has to be expected lower because of multiple comparisons.

Results: The following table shows selected study group characteristics and the significance of their correlation to the NCV of the peroneus nerve, which was the most sensitive. Pathologic results occurred in 73 %.

  % Median (range) p Value
Age at onset (y)   8.4 (1.7-15.1) 0.205
Male sex 57    
Antibodies found 90    
MODY 4    
Age at NCS (y)   14.5 (6.0-23.8) 0.002**
Duration of diabetes (y)   6.2 (0.6-18.4) 0.032*
Height at NCS (cm)   160.8 (120.4-186.5) 6.5x10-7**
CSII 51    
Sensor 71    
HbA1c at time of NCS (%)   8.0 (6.2-12.7) 0.040*
TIR at time of NCS (%)   54 (21-97) 0.240
SD of average glucose (mmol/l)   4.4 (1.3-6.8) 0.006*
Mean HbA1c last five years (%)   7.9 (6.1-14.2) 0.008*

Conclusion: The NCV of the peroneal nerve closely correlates with the control of diabetes and other risk factors of diabetic neuropathy, which can be present already in young patients.

Volume 95

60th Annual ESPE (ESPE 2022)

Rome, Italy
15 Sep 2022 - 17 Sep 2022

European Society for Paediatric Endocrinology 

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