Acute and Chronic Complications

Abstract

Introduction: Diabetic peripheral neuropathy (DPN) is a devastating complication to DM, potentially leading to diabetic foot ulcers. Studies using electrophysiology shows high occurrence of subclinical DPN among children, but it is unclear when and how to start screen children with T1D for DPN. Aim: To investigate whether evaluation of the vibrotactile sense, using a multi-frequency method, in the right hand and foot can detect underlying sensory neuropathy in children with T1D, and whether the DPN has any correlation to, for example, gender, age, duration of disease and metabolic control measured as HbA1c values. Methods: Vibration perception thresholds (VPTs), resulting in curves and numeric values, were evaluated using a VibroSense Meter. VPTs were related to normative data obtained from healthy children, and evaluated in relation to different characteristics. Subjects were 8-18 years old T1D patients. Subjects that failed to produce at least one visibly evaluable curve were excluded. Z-values of >2.0 were considered pathological. Subjects needed at least 3 pathological frequencies at the same site in order to claim the examined site as pathological. Results: 73 children (boys = 39) with mean age 13.2 [8.39-17.96] years and duration of T1D of 5.9 [0.54-14.58] years met the inclusion and exclusion criteria. On index and little fingers, 5/73 (6.8%) and 4/73 (5.5%) children respectively had pathological values. On metatarsal heads one and five, 9/73 (12.3%) children had pathological values on each site. In total 15/73 (21.0%) children had at least one pathological site and 3 (4.1%) had pathological values on all sites examined. Presence of pathological values on all sites correlated to the height of the subject (p = 0.011) but not to gender, duration of disease or HbA1c. Conclusion: Our findings suggests that DPN, reflected by impaired vibrotactile sense, is present among children with T1D. Since up to 21% of the children showed signs of impaired vibrotactile sense, it may be important to screen children with T1D for early detection of DPN. (Less)