Point prevalence of motor neuropathy in children and adolescents with type 1 diabetes mellitus

Abstract

Objectives: To conduct a screening for motor neuropathy in children and adolescents with type 1 diabetes to assess its point prevalence and to analyse potential risk factors associated with any positive motor neuropathy diagnosis. Methods: This is a cross-sectional study involving children aged 12 to 18 years who have been diagnosed with diabetes for five or more years and are receiving treatment with an insulin pump. All participants underwent a neurological examination and were questioned about symptoms of neuropathy. A nerve conduction study was conducted to evaluate the median, ulnar, common peroneal, and tibial motor nerves. Sensory nerves were also examined. The F-wave response of the tibial nerve was analysed, and needle electromyography was performed on a proximal and distal muscle of the lower limb. Results: A total of 29 children completed the study (mean age: 15.34 ± 1.56 years; mean duration of diabetes: 11.93 ± 2.84 years; HbA1c levels: 7.50 ± 1.17%). Results were normal, indicating adequate motor nerve integration and excluding the presence of motor neuropathy as well as peripheral neuropathy, even at subclinical level. Conclusion: In our studied population, which receives tight monitoring and support for diabetes management, using nerve conduction studies to detect early subclinical motor neuropathy shows no clear benefit. This finding was consistent even among individuals with poor metabolic control, altered albumin/creatinine ratio, and diabetes duration over 10 years, with no abnormalities observed. We recommend following the latest guidelines provided by the American Diabetes Association (ADA).