Diabetic polyneuropathy in children and adolescents: clinical picture and diagnosis

Abstract

The Department of Childhood and Adolescence Endocrinology, Russian Medical Academy of Postgraduate Training, Ministry of Health of the Russian Federation, examined 529 patients with type 1 diabetes mellitus (DM) whose age was 5 to 22 years. The study was undertaken to examine the prevalence and severity of diabetic peripheral polyneuropathy (DPN) in children, adolescents, and young individuals who fell ill with DM in childhood, to characterize the symptoms and neurological manifestations of this complication, and to choose adequate studies for their examination. DPN is most common in adolescents and young individuals having a longer history of the disease and worse values of compensation of carbohydrate metabolism. The specific feature of DPN in these age groups are the absence of severe forms of the disease and the presence of mainly the sensory pattern of disorders. The study defined the required scope of a neurological examination for early diagnosis of DPN in children and adolescents, which should include a thorough analysis of a patient’s complaints and a test by the Total Symptoms Score, a neurological examination by the modified Neuropathy Impairment Score for the Lower Extremities, stimulation electromyography of the sensory and motor nerves of the leg. By taking into account a poor DM compensation in the absolute majority of children and adolescents, the neurological examination should be regular at least once a year.