Median nerve entrapment neuropathy before and early after sleeve gastrectomy in patients with diabetes mellitus: a prospective cross-sectional study

Abstract

Entrapment neuropathies (EN) are common in all stages of diabetes mellitus (DM) and can be considered as a neurophysiological indicator of peripheral nerve damage and neuropathy in DM. Improved glycemic control has been observed after significant weight loss, following bariatric surgeries. Therefore, the aim of this study was to evaluate median nerve neuropathy and changes of other nerve conduction Study (NCS) parameters of the upper extremity after bariatric sleeve gastrectomy in patients with obesity and type 2 diabetes (T2D). This was a prospective cross-sectional study. Patients aged 18–58 years old with type 2 diabetes mellitus and BMI above 30 kg/m2 candidates for sleeve gastrectomy entered the study. All patients underwent a standard NCS of upper limbs including electrophysiologic study of the median and ulnar nerves before the operation and 3 months later. Fifteen patients entered the study (7 male and 8 female). Mean ± SD of BMI before and after surgery were 41.75 ± 3.90 and 33.83 ± 2.264 with a significant decrease. Severity of the median nerve entrapment neuropathy did not significantly change after the operation (0.572). Of all median and ulnar NCS parameters, nerve conduction velocity (NCV) of the right median and the left ulnar nerves significantly improved after surgery (P value = 0.004, P value = 0.009, respectively). The severity of median nerve entrapment neuropathy as a primary manifestation of diabetic neuropathy which was evaluated by electrodiagnostic study may not change early (3 months) after sleeve gastrectomy in patients with obesity and T2D. • BMI significantly changed 3 months after sleeve gastrectomy operation in patients with obesity. • Severity of median nerve neuropathy did not significantly change 3 months after sleeve gastrectomy surgery. • Most of the parameters of ulnar and median nerves did not significantly change 3 months after sleeve gastrectomy surgery.