Evidence for diabetic encephalopathy.
Auditory brain stem responses were recorded in 20 normoacoustic long-duration Type 1 diabetic patients (duration of diabetes 26 (range 13-46) years, age 44 (25-66) years) with peripheral neuropathy and retinopathy and in 19 sex-matched normoacoustic short-duration Type 1 diabetic patients (duration of diabetes 2 (0-6) years, age 23 (18-50) years) without clinical signs of neuropathy or microangiopathy. Abnormal brain stem auditory evoked responses were demonstrated in 40% of the long-duration and in 5.3% of the short-duration diabetic patients (p less than 0.01). Interpeak latencies Jv-JI and JIII-JI were significantly prolonged in both patient groups compared with the non-diabetic control group (p less than 0.01). Magnetic resonance imaging was performed in 16 of the long-duration patients and in 40 age-matched healthy volunteers on a whole body MR-scanner. Subcortical and/or brain stem lesions with abnormally high signals were seen in 69% of the long-duration Type 1 patients and in 12% of the healthy volunteers (p less than 0.02). Neuropsychological examination including 17 tests for intelligence and cognition were performed in the 20 long-duration Type 1 diabetic patients. The results indicated a performance close to that seen in a control group of healthy age-matched control subjects. Our study demonstrates that a considerable proportion of long-duration Type 1 diabetic patients suffering from retinopathy and peripheral neuropathy additionally have signs but no symptoms of central nervous system affection, diabetic encephalopathy.
Dejgaard
A
A
Hvidøre Hospital, Klampenborg, Denmark.
Gade
A
A
Larsson
H
H
Balle
V
V
Parving
A
A
Parving
H H
HH
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001933:Brain Stem / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology* / Q000523:psychology; D003928:Diabetic Nephropathies / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D003930:Diabetic Retinopathy / Q000503:physiopathology; D005072:Evoked Potentials, Auditory; D006442:Glycated Hemoglobin / Q000032:analysis; D006339:Heart Rate; D006801:Humans; D007858:Learning; D008279:Magnetic Resonance Imaging; D008568:Memory; D009483:Neuropsychological Tests; D014732:Vibration
D001786:Blood Glucose; D006442:Glycated Hemoglobin