Electroneurography of Right Median and Ulnar Nerves in Diabetic Patients With and Without Retinopathy

Emir Tupković,Mediha Nišić,Suzana Pavlješević,Samiha Salihović

doi:10.17305/bjbms.2007.3050

Emir Tupković, Mediha Nišić + Show 2 more

Open Access

https://doi.org/10.17305/bjbms.2007.3050

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Abstract

In this study we examined motor and sensory conduction velocities in right median and ulnar nerves in diabetic patients. Control group consisted of 25 healthy volunteers (13 males) with average age of 52 years. The first examined group consisted of 25 diabetic patients (13 males) without retinal changes, 59,6 years old on average, and the second group consisted of 40 patients (15 males) 59,4 years old on average: 22 of them with type 1, and 18 with type 2 retinal changes. The motor and sensory conduction velocities in right median nerve in the control group were significantly higher than those measured in the first group (p<0,0005 for motor, and p=0,0027 for sensory velocity), and the second group (p<0,0001 for motor, and p=0,0001 for sensory velocity). Significantly higher conduction velocities in sensory median nerve were compared between the examined groups (p<0,001), but motor conduction velocity was not significantly higher (p=0,09). The motor conduction velocity in ulnar nerve in the control group was significantly higher in comparison with the patients of first (p=0,0027) and second examined group (p=0,0001). The sensory conduction velocity in ulnar nerve was not significantly higher compared with the first (p=0,081), and significantly higher compared with the second examined group (p<0,0001). The sensory conduction velocity of ulnar nerve was significantly higher (p=0,019) in diabetic patients without retinopathy compared with patients with retinopathy. Diabetic patients with retinal changes have higher risk of developing more severe neurophysiologic signs of neuropathy. So, simple observation with ophthalmoscope may be useful diagnostic tool in its determination and may be the target of further therapeutic strategy.

Highlights

Diabetes mellitus (DM) is metabolic disorder with numerous and serious complications
In diabetic neuropathy metabolic mechanisms cause neural degeneration with regeneration problems, especially in tiny myelinic fibers, as opposed to microvascular changes that are essential in diabetic retinopathy ( )
The time, importance and microangiopathy stadium are controversial in diabetic neuropathy development

Summary

Introduction

Diabetes mellitus (DM) is metabolic disorder with numerous and serious complications. Basic metabolic disorder in this disease is breach in tissue oxygenation, which is very important factor for the appearance and progression of microangiopathy ( ). In diabetic neuropathy metabolic mechanisms cause neural degeneration with regeneration problems, especially in tiny myelinic fibers, as opposed to microvascular changes that are essential in diabetic retinopathy ( ). The time, importance and microangiopathy stadium are controversial in diabetic neuropathy development. In Chinese study on diabetics, retinopathy prevalence was , neuropathy , ( ) with obvious time of disease and glicaemic control. Research results of Schmid et al showed connection between cardiovascular autonomic neuropathy with diabetic retinopathy. There are too many studies that separately target diabetic retinopathy and neuropathy, but there are less studies that target the connections between these two diseases. The aim of this study is to understand this problem

Aims of study

Results and Discussion

Conclusion