[The role of 2,3-DPG in nerve conduction of children with type 1 diabetes].
BACKGROUND
Neuropathy is one of the chronic complications of diabetes, and it is uncommon in children and adolescents. It can be recognized in a short period after the onset of diabetes and not always is connected with poor metabolic control. Hypoxia is considered as one from greatest factors diabetic neuropathy and oxygen transport to tissue partially depends on the diphosphoglycerate (2,3 DPG) concentration. As showed recent clinical studies, its concentration in children with diabetes can be abnormal.


OBJECTIVE
To assess the role of 2,3 DPG in nerve conduction velocity, as well as qualification of risk factors.


METHODS
To study were included randomly selected 37 patients with diabetes type 1, average age 15.5+/-2.25 years, with a duration of diabetes of more than 5 years (av 9.64+/-1.95 years), treated with intensive insulin therapy (MDI and CSII), without metabolic acidosis pH - 7.35. The nerve conduction velocity was measured in the sensor and motor nerves. HbA1c and 2,3 DPG were assessed additionally.


RESULTS
Changes in motor nerve conduction velocity were observed at 22 patients. Average value of HbA1c in the studied group was 8.22+/-1.2%, Average concentration of 2,3 DPG was 6.15+/-1.67 mmol/l (3.84-11 mmol/l), in group with nerve dysfunction was lower - 5.86+/-1.69 mmol/l vs. 6.38+/-1.67, but this difference was not statistically significant. The lower value of 2,3 DPG significantly correlated with abnormal results of electroneurography test, especially with motor and sensor nerve latency (r=-0.34, p=0.038; r=-0.4, p=0.013) but not correlated with HbA1c (r= -0,19;p= 0,25), age of patients (r=0.008; p=0.96) and diabetes duration (r=-0.16; p=0.31).


CONCLUSIONS
Nerve dysfunction is common in children with type 1 diabetes despite metabolic control and duration of diabetes. 2,3 DPG can be an independent factor of diabetes neuropathy correlated with abnormal value of the nerve conduction test.
Pańkowska
Ewa
E
Klinika Diabetologii Dzieciecej, Patologii Noworodka i Wad Wrodzonych AM w Warszawie. epankowska@interia.pl
Szypowska
Agnieszka
A
Wysocka
Marta
M
Lipka
Maria
M
D019794:2,3-Diphosphoglycerate / Q000097:blood*; D000293:Adolescent; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D009431:Neural Conduction; D010525:Peripheral Nerves / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012307:Risk Factors
D019794:2,3-Diphosphoglycerate