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Early Electrophysiological Abnormalities and Clinical Neuropathy A prospective study in patients with type 1 diabetes
Karolinska Institute, Sweden .
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
Uppsala University, Sweden .
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
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2013 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 36, no 10, 3187-3194 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVEThe aim of this study was to elucidate whether subclinical nerve dysfunction as reflected by neurophysiological testing predicts the development of clinical neuropathy in patients with type 1 diabetes.RESEARCH DESIGN AND METHODSFifty-nine patients were studied twice with neurophysiological measurements at baseline and at follow-up. At baseline, patients were 15.5 3.22 years (range 7-22 years) of age, and duration of diabetes was 6.8 3.3 years. At follow-up, patients were 20-35 years of age, and disease duration was 20 +/- 5.3 years (range 10-31 years).RESULTSAt baseline, patients showed modestly reduced nerve conduction velocities and amplitudes compared with healthy subjects, but all were free of clinical neuropathy. At follow-up, clinical neuropathy was present in nine (15%) patients. These patients had a more pronounced reduction in peroneal motor nerve conduction velocity (MCV), median MCV, and sural sensory nerve action potential at baseline (P andlt; 0.010-0.003). In simple logistic regression analyses, the predictor with the strongest association with clinical neuropathy was baseline HbA(1c) (R-2 = 48%, odds ratio 7.9, P andlt; 0.002) followed by peroneal MCV at baseline (R-2 = 38%, odds ratio 0.6, P andlt; 0.006). With the use of a stepwise forward analysis that included all predictors, first baseline HbA(1c) and then only peroneal MCV at baseline entered significantly (R-2 = 61%). Neuropathy impairment assessment showed a stronger correlation with baseline HbA(1c) ( = 0.40, P andlt; 0.002) than with follow-up HbA(1c) ( = 0.034, P andlt; 0.007).CONCLUSIONSEarly defects in nerve conduction velocity predict the development of diabetic neuropathy. However, the strongest predictor was HbA(1c) during the first years of the disease.

Place, publisher, year, edition, pages
American Diabetes Association , 2013. Vol. 36, no 10, 3187-3194 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-100314DOI: 10.2337/dc12-2226ISI: 000324749500060OAI: diva2:661484

Funding Agencies|Swedish Child Diabetes Foundation (Barndiabetesfonden)||

Available from: 2013-11-04 Created: 2013-11-04 Last updated: 2014-11-12

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Ludvigsson, JohnnyWahlberg Topp, Jeanette
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Department of Medical and Health SciencesFaculty of Health SciencesDivision of Clinical SciencesDepartment of Paediatrics in LinköpingInternal MedicineDepartment of Endocrinology
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