Presence of neuropathy in children and adolescents with type 1 diabetes evaluated with bedside modalities

Damm Julie Agner; Amalie Dalgas-Madsen; Christian Hansen; Pilgaard Kasper Ascanius; Flemming Pociot; Hansen Tine Willum; Jesper Johannesen

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ESPE Abstracts (2024) 98 FC15.5

ESPE2024 Free Communications Late Breaking (6 abstracts)

Presence of neuropathy in children and adolescents with type 1 diabetes evaluated with bedside modalities

Julie Agner Damm ¹ , Amalie Dalgas-Madsen ¹ , Christian Hansen ¹ , Kasper Ascanius Pilgaard ^1,2 , Flemming Pociot ^1,3 , Tine Willum Hansen ^1,3 & Jesper Johannesen ^1,2,3

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¹Steno Diabetes Center Copenhagen, Herlev, Denmark. ²Herlev Hospital, Herlev, Denmark. ³University of Copenhagen, Copenhagen, Denmark

Aims: 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.

Methods: 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.

Results: 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.

Conclusion: 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.