title: Low peripheral nerve conduction velocities and amplitudes are strongly related to diabetic microvascular complications in type 1 diabetes: the EURODIAB Prospective Complications Study.
abstract: 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.
authors.affiliation: School of Public Health, Aarhus University, Aarhus, Denmark. mc@alm.au.dk
authors.forename: Morten
authors.initials: M
authors.lastname: Charles
authors.forename: Sabita S
authors.initials: SS
authors.lastname: Soedamah-Muthu
authors.forename: Solomon
authors.initials: S
authors.lastname: Tesfaye
authors.forename: John H
authors.initials: JH
authors.lastname: Fuller
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Arezzo
authors.forename: Nishi
authors.initials: N
authors.lastname: Chaturvedi
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Witte
mesh_terms: 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
chemical_list: D006442:Glycated Hemoglobin
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