What does nerve ultrasound contribute to the evaluation of diabetic polyneuropathy over time? A prospective follow-up observational study of people with type 2 diabetes

IF 6.1 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-03-18 DOI:10.1016/j.diabres.2025.112115

Bianka Heiling , Thomas Lehmann , Nicolle Müller , Christof Kloos , Alexander Grimm , Gunter Wolf , Hubertus Axer

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Abstract

Aims

Studies using peripheral nerve ultrasound have shown moderate nerve enlargement in individuals with diabetic polyneuropathy (DPN). Neither extent, course, consistency, nor clinical significance of this finding is clear.

Method

We examined 156 people with type 2 diabetes mellitus using nerve ultrasound, nerve conduction studies, and clinical scores. 59 received a follow-up examination after one year and 43 patients after two years.

Results

Increase of cross-sectional area (CSA) of the peripheral nerves in DPN was rather negligible compared to normative cut-off values. The CSA of the median nerve at the forearm and wrist and the ulnar nerve at the upper arm, forearm and wrist were significantly larger in individuals with DPN compared to those without DPN. People with DPN had significant changes in most parameters of nerve conduction studies. Ultrasound measurements over time showed a slight increase in CSA in the median nerve at the carpal tunnel and a slight decrease in the fibular nerve at the fibular head. Ultrasound pattern sum score slightly decreased in the DPN group over two years.

Conclusions

Ultrasound measurements alone may be insufficient to detect DPN. Follow up with nerve ultrasound over one or two years was short and did not show substantial changes.

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目的：使用周围神经超声波进行的研究显示，糖尿病多发性神经病变（DPN）患者的神经有中度肿大。这一发现的程度、病程、一致性和临床意义均不明确：我们使用神经超声、神经传导研究和临床评分对 156 名 2 型糖尿病患者进行了检查。59名患者在一年后接受了随访检查，43名患者在两年后接受了随访检查：结果：与正常临界值相比，DPN 患者周围神经横截面积（CSA）的增加几乎可以忽略不计。与非 DPN 患者相比，DPN 患者前臂和腕部正中神经以及上臂、前臂和腕部尺神经的 CSA 明显增大。DPN患者的大多数神经传导研究参数都有明显变化。超声波测量结果显示，正中神经腕隧道处的 CSA 随时间推移略有增加，腓骨神经腓骨头处的 CSA 则略有减少。两年来，DPN 组的超声模式总分略有下降：结论：仅靠超声测量可能不足以检测出 DPN。神经超声随访一两年的时间较短，并未显示出实质性的变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.