ECEESPE2025 Poster Presentations Diabetes and Insulin (143 abstracts)
Early detection of peripheral and autonomic neuropathy in children and adolescents with type 1 diabetes mellitus
Yaprak Ece Yola Atalah 1 , Volkan Taşdemir 2 , Nermin Gorkem Sirin 2 , Melike Cevikdizici 3 , Ummu Mutlu 3 , Aslı Derya Kardelen Al 1 , Melek Yildiz 1 , Sukran Poyrazoglu 1 , Feyza Darendeliler 1 , Kubilay Karsidag 3 , Mehmet Baris Baslo 2 , Firdevs Bas 1 & Elif Kocasoy Orhan 2
1Istanbul University, Istanbul Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Türkiye; 2Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Türkiye; 3Istanbul University, Istanbul Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul, Türkiye
JOINT2391
Introduction: Clinical neuropathy manifestations emerge during the initial stages of diabetes in children with type 1 diabetes mellitus (T1DM). Early detection and intervention of these changes leading to neuropathy are crucial for the follow-up of patients diagnosed with T1DM. Our objective was to identify a more sensitive method that can be implemented in clinical settings for the early detection of neuropathy in children. The present data constitute initial findings from our pilot study.
Methods: Thirty-one children with T1DM aged 6-18 years were evaluated using nerve conduction studies (NCS) (motor and sensory), autonomic tests (sympathetic skin responses and R-R interval variability studies), Sudoscan®, and neuropathy screening questionnaires (Composite Autonomic Symptom Score-31 (COMPASS-31) and Michigan Neuropathy Screening Instrument (MNSI)).
Results: This study recruited 31 children (F/M: 15/16), two of whom were prepubertal. The mean age of the T1DM patients was 13. 8±2. 9 years and mean duration of diabetes was 6. 1±1. 8 years. Mean insulin requirement of the study population was 1. 1±0. 4 U/kg/day, while their mean HbA1c level in the preceding year was 9. 2%±1. 8. All nerve conduction studies were within normal ranges, except for one patient. The COMPASS-31 scores were within the normal range for all the patients. The Sudoscan® results were within the normal range for all patients, except for one patient who exhibited moderate risk. Although within normal ranges, the median, peroneus, and tibial nerve motor latencies and amplitudes of the medial plantar and sural sensory nerves were affected by the duration of diabetes (P < 0. 05). Our research has demonstrated that prolonged diabetes duration correlates with diminished amplitudes and extended latencies in the aforementioned nerves. Multivariate regression analysis showed that T1DM duration was significantly associated with peroneus motor latency (β=5. 164, P = 0. 011), tibial motor conduction velocity (β=-1. 748, P = 0. 006), total COMPASS-31 score (β=0. 254, P = 0. 010), Sudoscan® foot mean value (β=-0. 229, P = 0. 013), and HbA1c level (β=-2. 069, P = 0. 004) (R2=0. 73). The results of this study suggest that duration of diabetes affects autonomic dysfunction and electrophysiological parameters in the pediatric population.
Conclusion: In children with T1DM, screening for diabetic neuropathy is recommended during the early stages. It may be possible to detect early changes in the pediatric population using nerve conduction studies, autonomic tests, Sudoscan®, and diabetic neuropathy screening. To detect early changes, it also seems important to determine normative data for NCS in the pediatric population.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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