P613: Detection of early neuropathy in type 2 diabetes mellitus

Abstract

s of Poster Presentations / Clinical Neurophysiology 125, Supplement 1 (2014) S1–S339 S215 P612 Small and large fibre neuropathy in patients with diabetes type 1 compared with type 2: a follow-up study S. Loseth1,2, E. Stalberg3, S. Lindal4, R. Jorde5, S.I. Mellgren6 1University of Tromso, Tromso, Norway; 2University Hospital of North Norway, Department of Clinical Neurophysiology, Tromso, Norway; 3Uppsala University Hospital, Department of Clinical Neurophysiology, Uppsala, Sweden; 4University Hospital of North Norway, Department of Pathology, Tromso, Norway; 5University Hospital of North Norway, Department of Internal Medicine, Tromso, Norway; 6University Hospital of North Norway, Department of Neurology, Tromso, Norway Question: Are there differences in the spectrum of large and small fibre involvement in patients with diabetes type 1 versus those with type 2? Methods: Fifty-nine patients (35 type 1 and 24 type 2 diabetes) were included in a follow-up study after 5 years. Nerve conduction studies (NCS), quantitative sensory testing (QST) at the distal calf and skin biopsy for quantification of intraepidermal nerve fibre density (IENFD) in addition to symptom scoring and clinical evaluations were performed. Z-scores were calculated to adjust for the physiologic effects of age, height and gender. Results: Patients with type 1 diabetes were younger with longer disease duration; they had higher HbA1c and lower BMI. Neuropathic symptoms tended to be more frequent in type 2 (54% versus 37%; ns). Comparing data to the baseline study, the overall NCS score was more abnormal after 5 years in both type 1 (p=0.006) and type 2 diabetes (p=0.02). IENFD became significantly lower only in those with type 2 (reduction from 7.9±4.8 to 4.3±2.8 fibres/mm, p=0.006). Cold perception threshold was higher in type 2 at follow-up compared to baseline (p=0.049). Between the two types of diabetes the difference of progression of abnormalities was only significant for the IENFD (more progression in type 2, p=0.048). Conclusions: A 5 year follow-up study in diabetics showed progression of large fibre neuropathy in both type 1 and type 2. Small fibre neuropathy seems to progress more rapidly in those with type 2. P613 Detection of early neuropathy in type 2 diabetes mellitus R. Remli1, S.A. Md Rani1, W.N.N. Wan Yahya1, R. Sahathevan1, Z. Md Zain2, N. Mohamed Ibrahim1, R. Azman Ali1, H.J. Tan1 1National University of Malaysia, Medical Department, Kuala Lumpur, Malaysia; 2National University of Malaysia, Community Health Department, Kuala Lumpur, Malaysia Question: To determine the frequency and predictors of asymptomatic lower limb neuropathy amongst type 2 diabetic patients in University Kebangsaan Malaysia Medical Centre (UKMMC). Methods: This was a cross sectional study which recruited diabetic patients in UKM Medical Centra who did not have any neuropathy symptoms. All patients who obtained a score of “0” in diabetic neuropathy symptoms score (unsteadiness in walking, neuropathic pain, paraesthesia, numbness [1] (Table 1). Figure 1. The frequency of nerve conduction parameters abnormalities in motor and