title: Electrophysiologic pattern and prevalence of subclinical peripheral neuropathy in children and adolescents with type I diabetes mellitus in Iran.
abstract: OBJECTIVE
  To evaluate electrophysiologic pattern of subclinical diabetic peripheral neuropathy (DPN) in children and adolescents with type 1 diabetes mellitus (T1DM) based on nerve conduction study.
  
  
  METHODS
  In this cross sectional study, 40 children and adolescents (62.5% female with mean age of 12.73 ± 0.43 years) with T1DM for at least 5 years attending the Pediatrics Clinics. Tabriz University of Medical Sciences, Tabriz, Iran, between 2014 and 2015 were recruited. Demographic and laboratory findings were recorded and all patients underwent clinical neurological examination and electrophysiologic studies.
  
  
  RESULTS
  According to electrophysiologic studies, DPN was found in 57.5% of patients including early stage of neuropathy (15%), mild sensory axonal neuropathy (25%), mild sensory motor axonal neuropathy (10%), and moderate sensory motor axonal neuropathy (7.5%). Age, duration of diabetes, fasting blood sugar, and glycosylated hemoglobin levels had no significant difference between patients with and without DPN. Reduced deep tendon reflexes were observed in the upper limb (30%) and lower limb (47.5%) of patients, which were both significantly higher in DPN patients (upper limb [p=0.03] and lower limb [p=0.04]). The most frequent electrophysiologic findings were unobtainable H-reflex, low amplitude sural, and median sensory responses.
  
  
  CONCLUSIONS
  Subclinical DPN is a common complication found in children and adolescents with TIDM and peripheral sensory axonal neuropathy is the most frequent type. Nerve conduction study is recommended for early detection of DPN and prevention of its progress.
authors.affiliation: Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. E-mail. toopchi@tbzmed.ac.ir.
authors.forename: Vahideh
authors.initials: V
authors.lastname: Toopchizadeh
authors.forename: Siamak
authors.initials: S
authors.lastname: Shiva
authors.forename: Nader-Yousefzadeh
authors.initials: NY
authors.lastname: Khiabani
authors.forename: Robabeh
authors.initials: R
authors.lastname: Ghergherechi
mesh_terms: D000293:Adolescent; D058070:Asymptomatic Diseases; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000209:etiology* / Q000503:physiopathology; D055724:Electrophysiological Phenomena; D006801:Humans; D007492:Iran; D009431:Neural Conduction; D012720:Severity of Illness Index