Low peripheral nerve conduction velocities and amplitudes are strongly related to diabetic microvascular complications in type 1 diabetes: the EURODIAB Prospective Complications Study.
OBJECTIVE
Slow nerve conduction velocity and reduction in response amplitude are objective hallmarks of diabetic sensorimotor polyneuropathy. Because subjective or clinical indicators of neuropathy do not always match well with the presence of abnormal nerve physiology tests, we evaluated associations to nerve conduction in patients with type 1 diabetes.


METHODS
Nerve conduction studies were performed in the distal sural and ulnar sensory nerves and the peroneal motor nerve in 456 individuals with type 1 diabetes who participated in the follow-up visit of the EURODIAB Prospective Complications Study (EPCS). We used multivariate regression models to describe associations to decreased nerve conduction measures.


RESULTS
In addition to an effect of duration of diabetes and A1C, which were both associated with low nerve conduction velocity and response amplitude, we found that the presence of nephropathy, retinopathy, or a clinical diagnosis of neuropathy was associated with low nerve conduction velocity and amplitude. In the case of nonproliferative retinopathy, the odds ratio (OR) for being in lowest tertile was 2.30 (95% CI 1.13-4.67) for nerve conduction velocity. A similar OR was found for each 2% difference in A1C (2.39 [1.68-3.41]).


CONCLUSIONS
We show that the presence of other microvascular diabetes complications, together with diabetes duration and A1C, are associated with low nerve conduction velocity and amplitude response and that cardiovascular disease or risk factors do not seem to be associated with these measures.
Charles
Morten
M
School of Public Health, Aarhus University, Aarhus, Denmark. mc@alm.au.dk
Soedamah-Muthu
Sabita S
SS
Tesfaye
Solomon
S
Fuller
John H
JH
Arezzo
Joseph C
JC
Chaturvedi
Nishi
N
Witte
Daniel R
DR
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D009431:Neural Conduction / Q000502:physiology*; D010525:Peripheral Nerves / Q000503:physiopathology*; D055815:Young Adult
D006442:Glycated Hemoglobin
Ann Intern Med. 1995 Apr 15;122(8):561-8
7887548
Diabetes Care. 2005 Sep;28(9):2192-200
16123489
Ann Neurol. 1995 Dec;38(6):869-80
8526459
Diabetes Care. 2006 Oct;29(10):2282-8
17003307
Kaohsiung J Med Sci. 2005 Jan;21(1):15-21
15754584
Diabetes Care. 2001 Feb;24(2):284-9
11213880
Diabetes Care. 2008 Mar;31(3):464-9
18039804
Eur Neurol. 2007;57(2):91-5
17179711
Diabetes. 2009 Jul;58(7):1634-40
19411614
Diabetologia. 2001 Nov;44(11):1973-88
11719828
Neurology. 1993 Apr;43(4):817-24
8469345
Neurology. 2005 Jan 25;64(2):199-207
15668414
Diabetes Care. 1998 Oct;21(10):1749-52
9773742
Diabetologia. 1996 Nov;39(11):1377-84
8933008
Diabetes Care. 2007 Oct;30(10):2613-8
17644617
Diabetes Care. 2007 Oct;30(10):2619-25
17513707
N Engl J Med. 2005 Jan 27;352(4):341-50
15673800
Muscle Nerve. 1992 Oct;15(10):1095-104
1406766
Diabetologia. 1994 Mar;37(3):278-85
8174842
Diabetologia. 1996 Dec;39(12):1483-8
8960830
Neurology. 1996 Jan;46(1):85-91
8559426
J Diabetes Complications. 1997 Jan-Feb;11(1):27-34
9025010