A Comparative Peripheral Nerve Conduction Study in Type-2 Diabetics with Symptoms of Polyneuropathy with Age and Sex Matched Normal Subjects

Abstract

Background: Diabetes Mellitus is one among the diseases that affects peripheral nervous system and symptomatic Neuropathy in uncontrolled Diabetes is one of the commonest incapacitating complications. Electro diagnostic tests can be used to detect Diabetic Neuropathy at an early stage (before development of the signs or symptoms of Neuropathy). Nerve Conduction Study (NCS) is considered to be the most sensitive, reliable, non-invasive and objective means of investigations of Diabetic Polyneuropathy. Diabetic Neuropathy is curable, and hence if detected, the proper treatment can be instituted in early stages, which again, can give rise to good outcome. As the peripheral nerve has the ability to regenerate, line of treatment can be planned. Aims & Objectives: To compare and analyze the peripheral nerve conduction studies in symptomatic diabetic neuropathy cases with age and sex matched normal subjects emphasizing on use of Nerve conduction studies as a diagnostic approach to prevent Severe Neuropathy. Methods: The study group consists of 9 cases diagnosed with Diabetic neuropathy referred to our neurophysiology lab and control group consists of 9 age and sex matched normal subjects who are nondiabetic, healthy volunteers. Statistical analysis was done using unpaired t-test and 8 out of 9 cases considered for statistical analysis. Motor and Sensory nerve conduction studies conducted in both Upper (Median and Ulnar nerves) and Lower limbs (Tibial and Peroneal nerves) using bipolar surface electrodes with RMS EMG EP MARK-II machine. Results: There is a definite decrease in amplitude and nerve conduction velocities of both the sensory and motor components, axonal and demyelinating type significantly correlating with higher HBA1c levels. F minimum latencies of Median, Tibial and Peroneal nerves were increased possibly more of demyelinating type of Polyneuropathy. Conclusion: NCS being a simple, harmless, non-invasive and objective technique along with easy interpretation of results can be used routinely to evaluate the status of nerves in patients with Type 2 Diabetes Mellitus to prevent more disabling state at the earliest.