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Vol 6, No 4 (2017)
Original articles (submitted)
Published online: 2017-11-17
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Electrophysiological status of sural nerves in type 2 diabetes mellitus patients before symptomatic peripheral neuropathy

Raju Panta, Dilip Thakur, Bishnu Hari Paudel
DOI: 10.5603/DK.2017.0021
·
Clinical Diabetology 2017;6(4):126-130.

open access

Vol 6, No 4 (2017)
Original articles (submitted)
Published online: 2017-11-17

Abstract

Introduction. Neuropathies in type 2 diabetes mellitus (T2DM) patients are well known. However, electrophysiological changes in their peripheral nerves, particularly before overt peripheral neuropathy have received much less attention. Hence, we aimed to study the electrophysiological status of bilateral sural nerves in T2DM patients who do not show symptoms and signs of peripheral neuropathy.

Material and methods. We selected 35 T2DM male patients and 35 age- and sex-matched control subjects without any clinical evidence of peripheral neuropathy and infectious, systemic, metabolic, and neuropsychiatric illnesses after informed written consent. Nerve conduction study (NCS) of bilateral sural nerves of both the groups was done at the lab temperature of 26 ± 2ºC by antidromic method of stimulation using standard methods. Their latency, conduction velocity, amplitude, and duration of bilateral sural sensory nerve action potentials (SNAPs) were measured and compared.

Results. T2DM patients had reduced amplitudes of bilateral sural SNAPs compared to control subjects [left (12.46 ± 3.77) μV vs. (16.42 ± 4.58) μV, p = 0.000; right (11.96 ± 4.45) μV vs. (16.62 ± 6.20) μV, p = 0.001] though they were above the normal cut-off value of ≥ 4 μV. T2DM patients showed prolonged durations of bilateral sural SNAPs compared to the control subjects [left (1.99 ± 0.38) ms vs. (1.67 ± 0.27) ms, p = 0.000; right (1.92 ± 0.47) ms vs. (1.55 ± 0.33) ms, p = 0.000].

Conclusion. Reduced amplitudes and prolonged durations of bilateral sural SNAPs are the electrophysiological alterations, suggestive of peripheral neuropathy, in T2DM patients that appear before they show clinical symptoms and signs of peripheral neuropathy.

Abstract

Introduction. Neuropathies in type 2 diabetes mellitus (T2DM) patients are well known. However, electrophysiological changes in their peripheral nerves, particularly before overt peripheral neuropathy have received much less attention. Hence, we aimed to study the electrophysiological status of bilateral sural nerves in T2DM patients who do not show symptoms and signs of peripheral neuropathy.

Material and methods. We selected 35 T2DM male patients and 35 age- and sex-matched control subjects without any clinical evidence of peripheral neuropathy and infectious, systemic, metabolic, and neuropsychiatric illnesses after informed written consent. Nerve conduction study (NCS) of bilateral sural nerves of both the groups was done at the lab temperature of 26 ± 2ºC by antidromic method of stimulation using standard methods. Their latency, conduction velocity, amplitude, and duration of bilateral sural sensory nerve action potentials (SNAPs) were measured and compared.

Results. T2DM patients had reduced amplitudes of bilateral sural SNAPs compared to control subjects [left (12.46 ± 3.77) μV vs. (16.42 ± 4.58) μV, p = 0.000; right (11.96 ± 4.45) μV vs. (16.62 ± 6.20) μV, p = 0.001] though they were above the normal cut-off value of ≥ 4 μV. T2DM patients showed prolonged durations of bilateral sural SNAPs compared to the control subjects [left (1.99 ± 0.38) ms vs. (1.67 ± 0.27) ms, p = 0.000; right (1.92 ± 0.47) ms vs. (1.55 ± 0.33) ms, p = 0.000].

Conclusion. Reduced amplitudes and prolonged durations of bilateral sural SNAPs are the electrophysiological alterations, suggestive of peripheral neuropathy, in T2DM patients that appear before they show clinical symptoms and signs of peripheral neuropathy.

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Keywords

diabetes mellitus, peripheral neuropathy, nerve conduction study, sural SNAP, axonal loss

About this article
Title

Electrophysiological status of sural nerves in type 2 diabetes mellitus patients before symptomatic peripheral neuropathy

Journal

Clinical Diabetology

Issue

Vol 6, No 4 (2017)

Pages

126-130

Published online

2017-11-17

DOI

10.5603/DK.2017.0021

Bibliographic record

Clinical Diabetology 2017;6(4):126-130.

Keywords

diabetes mellitus
peripheral neuropathy
nerve conduction study
sural SNAP
axonal loss

Authors

Raju Panta
Dilip Thakur
Bishnu Hari Paudel

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