Evaluation of neurographic parameters in diabetic neuropathy
Diabetic neuropathy is a frequent complication of patients suffering from diabetes mellitus (either type I or type II diabetes). The clinical picture of this disease varies widely from non-symptomatic courses to severe disabling and potential life-threatening cases, mostly due to autonomic neuropath...
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|Diabetic neuropathy is a frequent complication of patients suffering from diabetes mellitus (either type I or type II diabetes). The clinical picture of this disease varies widely from non-symptomatic courses to severe disabling and potential life-threatening cases, mostly due to autonomic neuropathy. The treatment of diabetic neuropathy is despite huge investments in clinical research mostly related to an effective control of blood glucose levels. Beside acute courses of diabetic neuropathy, which tend to remit, most patients suffer from chronic courses of diabetic neuropathy, where distal symmetric neuropathy is the most common course of disease. These cases are usually chronic progressive, therefore early diagnosis and intervention is mandatory. The advantages of neurographic testing as diagnostic tool in terms of reliability, validity, relevance, and patient’s safety is well accepted. Used by medical professionals this method provides information about the functional status of the peripheral nervous system. This study was conducted comparing normal subjects and patients with diabetes mellitus or impaired glucose tolerance, who with suspicion of diabetic neuropathy. The aim of this study was to identify additional neurographic markers who can differentiate between the two patient groups in order to possibly provide a diagnostic tool for the early di-agnosis of diabetic neuropathy. These markers should supplement the markers already es-tablished so as maximum nerve conduction velocity or amplitude of the compound muscle action potential. The evaluation of further markers so as further conduction velocities, posi-tive/negative amplitudes, quotients of intervals/amplitudes/areas revealed significant differ-ences between the two patient groups, nevertheless also the standard markers demon-strated significant differences. These findings could be related to the fact, that the average age in group 2 with diabetic patients was substantially higher than in group 1 with normal subjects. In addition the progression of diabetic neuropathy could be more advanced, so that an additional study with patients in an earlier stage of disease and comparable age could im-prove the diagnosis of early diabetic neuropathy.