Marianna Tóth , Annamária Szőke , Zsuzsanna Arányi
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Nerve ultrasonographic findings in diabetes mellitus are determined by anatomical location and type of diabetes
Objective
A prospective ultrasound study to analyze nerve size and its modifying factors in type 1 and type 2 diabetes mellitus.
Methods
The cross-sectional areas (CSAs) of motor and sensory nerves in both upper and lower limbs were measured at 14 measurement points, using high resolution ultrasound in 26 patients with type 1 and 76 patients with type 2 diabetes, and in 50 control subjects. All diabetic patients underwent electrophysiological assessment to check for the presence of polyneuropathy.
Results
Significant mild/moderate diffuse nerve enlargement was demonstrated in type 2 diabetes, more pronounced at compression sites versus non-compression sites, and on the upper limbs versus lower limbs (p value for pooled DM2 v. control group: <0.001). In type 1 diabetes, nerve enlargement was found only at one compression site (median nerve wrist; p = 0.002). No significant difference was found between patients with or without polyneuropathy.
Conclusions
The primary predictors of nerve size in diabetes are anatomical location (i.e. compression sites versus non-compression sites, upper versus lower limbs) and type of diabetes. Changes occur before the electrophysiological signs of polyneuropathy are detected.
Significance
Nerve ultrasound may contribute to early recognition of the neuropathic complications of diabetes.
期刊介绍:
Clinical Neurophysiology Practice (CNP) is a new Open Access journal that focuses on clinical practice issues in clinical neurophysiology including relevant new research, case reports or clinical series, normal values and didactic reviews. It is an official journal of the International Federation of Clinical Neurophysiology and complements Clinical Neurophysiology which focuses on innovative research in the specialty. It has a role in supporting established clinical practice, and an educational role for trainees, technicians and practitioners.