A Comparative Study of Sensory and Motor Peripheral Nerve Functions in Elderly Patients of Diabetes Mellitus and Non-Diabetic Controls in a Tertiary Care Hospital

Abstract

Introduction: In elderly diabetics, peripheral neuropathy is a significant cause of morbidity and physical disability. Diabetes Mellitus, and its chronic complications like peripheral neuropathy have been instrumental in contributing to the physical decline in the elderly. However, objective assessment of physical ability in elderly diabetics and devising their correlation to reduced peripheral nerve functions has been a hitherto uncharted territory. This study aims at evaluating the peripheral nerve functions in elderly diabetics. This study hypothesizes that peripheral nerve functions were significantly reduced in elderly diabetics in comparison to elderly nondiabetics. Materials and Method: Relevant history, prescriptions and laboratory reports were collected from the study participants. Sensory functions were tested by 10g Semmes-Weinstein Monofilament Test and Vibration Perception Threshold (VPT) was tested by handheld biothesiometer. Motor functions were tested by the Compound Muscle Action Potential and Nerve Conduction Velocity (CMAP and NCV respectively) for the peroneal nerve (preferably of right side). Fisher exact test has been applied barring the parameters for nerve function with respect to Monofilament and VPT. For Monofilament and VPT, Z statistic has been used to test the differences in proportion. Results: Most of the diabetic patients were overweight. NCV and CMAP were significantly reduced in diabetics. Mean NCV in diabetic group was 37.81 m/s as compared to 42.08 in non-diabetic. Mean CMAP in diabetics was 2.55 mV as compared to 3.21 mV in non-diabetic. Our study showed that number of participants with impaired VPT and monofilament test was higher in diabetics than non-diabetics. Conclusion: Diabetic patients are more prone to develop peripheral neuropathy. Assessment of the clinical homologue of these pathological processes is the first step in implementing the appropriate type of intervention. Treatment should be individualized to take into account specific manifestations and the underlying pathogenesis of each patient's unique clinical presentation. Keywords: Diabetes Mellitus, Nerve Function, Peripheral Neuropathy.