ASSESSMENT OF NEUROMUSCULAR JUNCTION INTEGRITY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Abstract

Background:Diabetes Mellitus produces long-term damage and failure of various tissues, in particular, diabetes-induced neural damage. Changes of neuromuscular transmission would contribute to the progressive weakness in diabetic patients; Electrophysiological studies are of recognized use in the confirmation of alterations of neuromuscular transmission and helping to differentiate them from other conditions. The current study was performed to evaluate the integrity of neuromuscular junction (NMJ) in patients with type 2 diabetes using repetitive nerve stimulation (RNS) technique and assessment of acetylcholine receptors antibodies in the serum. Patients and Methods:This cross-sectional study involved 103 patients with type 2 diabetes mellitus. The entire subjects met certain inclusion and exclusion criteria to exclude other possible contributing factors of neuropathy. All subjects completed a pre-requested questionnaire, then physical and neurological examinations were done, routine nerve conduction study, repetitive nerve stimulation and assessment of acetylcholine receptors antibodies were performed. Results:Among 103 patients with type 2 DM patients 56 of them were diagnosed as peripheral polyneuropathy however, the rest (47) their NCS result were normal, 11 (10.7%) of them showed positive decrement test, All those with positive decrement test they have also peripheral polyneuropathy, serum acetylcholine receptor antibody test was negative in all the participants (those with positive and negative decrement test). Conclusions:This preliminary study implies that type 2 diabetes contributes to the neuromuscular junction dysfunction. Further studies are indicated to explain the pathophysiology and mechanisms responsible for positive decrement test in type 2 diabetic patients. Duhok Med J 2019; 13 (1):1-8.