Electrophysiological Changes of Sensory Nerves in Patients with Type-2 Diabetes Mellitus of Different Duration

Sarmin Sultana ,Noorzahan Begum,Zinia Perveen,Liaquat Ali,Shahana Parveen,Nirmelendu Bikash Bhowmik,Mm Hossain

doi:10.3329/bsmmuj.v3i1.5507

Abstract

Background: Peripheral neuropathy is a common complication of diabetes mellitus. Among the diabetic neuropathies symmetrical sensory polyneuropathy is the most common one. Abnormalities of sensory nerve conduction are features of diabetic nerve damage. Significant association has been found between electrophysiological parameters of sensory nerves and duration of metabolic derangement in patients with diabetic neuropathy. Objectives: The present study was designed to characterize nerve conduction abnormalities of sensory nerves in subjects with type 2 diabetes mellitus of different duration and also to assess whether duration of diabetes has any influence on the sensory nerve function. Methods: Forty-four type 2 diabetic subjects were included in two groups:- Group B 1 consisted of 23 diabetic subjects having duration of diabetes for 5-10 years (shorter duration) and Group B 2 consisted of 21 diabetic subjects having duration of diabetes for 10-15 years (longer duration). Twenty-five age and BMI matched healthy subjects without family history of diabetes were included as Group A (control) subjects. Sensory nerve conduction velocities, action potential amplitudes and latencies of ulnar and sural nerves were measured by a standard NCV-EMG equipment. Result: No significant changes in sensory nerve conduction parameters were observed in the group of diabetic subjects having shorter duration of diabetes. In the diabetic group with relatively longer duration of diabetes some of the sensory nerve conduction parameters were affected. Among them S SNAP and S NCV were significantly (P<0.01 and <0.05 respectively) reduced in diabetic group with relatively longer duration of diabetes. Conclusion: The results of the study indicated that neuronal dysfunction for sensory nerves appears after a prolonged exposure to hyperglycemia; there may also be some genetic and biochemical basis (other than hyperglycemia) for early sensory sparing in type 2 diabetic population of Bangladesh. DOI: 10.3329/bsmmuj.v3i1.5507 BSMMU J 2010; 3(1): 9-12

Highlights

Peripheral neuropathy is a common and disabling complication of diabetic mellitus
The exact etiology and pathogenesis of neuropathy is still uncertain, many investigators reported that metabolic changes contribute to diabetic neuropathy[1]
The study was carried out on 44 diagnosed type-2 diabetic patients with different duration of diabetes suffering from neuropathy (Group B); 25 age and BMI matched apparently healthy subjects were included in the study as control (Group A) Group B was further divided into Group B1 which consisted of 23 diabetic subjects with duration of diabetes from 5 to 10 years(shorter duration) and Group B2 which consisted of 21 diabetic subjects with duration of diabetes for more than 10 years

Summary

Introduction

Peripheral neuropathy is a common and disabling complication of diabetic mellitus. The exact etiology and pathogenesis of neuropathy is still uncertain, many investigators reported that metabolic changes contribute to diabetic neuropathy[1]. Symmetrical sensory polyneuropathy, the most common of the diabetic neuropathy is considered to have a metabolic cause[2]. There is evidence that the duration of impaired diabetic control, in particular, contributes to disturbed nerve function[3]. Sensory, motor and autonomic functions are affected in varying degrees with sensory function predominating[4]. Sensory nerve conduction is believed to be more impaired than motor nerve conduction; sensory nerve conduction velocity is diminished and amplitude potentials are reduced early in diabetic neuropathy[5]

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