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Original Research



Study on electrophysiological changes of peripheral nerves in type 2 diabetes mellitus

Sulata Mohapatra, Birajman Lakra, Umakant Satapathy.




Abstract

Background: Peripheral neuropathy is a common and disabling complication due to diabetes mellitus. In such neuropathy, the function of sensory neurons, motor neurons, and autonomic functions are affected. The involvement of sensory function predominates in majority of cases. The neuropathy when develops is not reversible and also can not be stopped with any modality of treatment.

Aim and Objectives: The objective is to evaluate diabetic neuropathy using the electrodiagnostic studies which are considered as a valuable tool. These studies are sensitive, specific, reproducible, and easily standardized.

Material and Methods: Forty patients were subjected to electrodiagnostic study to evaluate the status of peripheral nerves in type- 2 diabetic patients. The different conduction velocities (motor nerve conduction velocity [MNCV], sensory nerve conduction velocity [SNCV]), distal latency (DL), nerve action potential (sensory nerve action potential [SNAP], and combined muscle action potential [CMAP]) are studied. All the cases were divided into two groups based on normal and abnormal diabetic neuropathy score. Sex, body mass index matched thirty numbers of healthy adults of both sexes were included in the control group. Nerve conduction study (NCS) of all the three groups were compared.

Result: Neuropathy mostly peripheral was observed in 15 (37.5%) cases. The age of majority of cases was from 50–60 (45%) with mean age of 52.42 ± 7.39, having predominance of male (66.67%) in cases with symptoms of neuropathy. Fourteen (93.33%) cases out of the above cases had abnormal NCS. Abnormal NCS was also found in cases without clinical neuropathy, i.e. 14 (56%). The mean values of CMAP, SNAP, MNCV, and SNCV with prolonged DL are observed which was statistically significant. The conduction defect was observed more in lower limbs than in upper limbs. In the category of the motor nerve (common peroneal) is the most affected whereas the most affected sensory nerve was Sural nerve.

Conclusion: Affection of nerves with neuropathies due to diabetes was in Sensory nerve than motor nerve. Early screening for neuropathy in clinical practice with NCSs can help in early diagnosis and their management.

Key words: Common Peroneal Nerve; Sural Nerve; Electrophysiological Studies; Nerve Conduction Studies; Diabetic Neuropathy






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