Nerve conduction studies and renal function were evaluated prospectively in 144 diabetic children followed from the time of diagnosis and at 2, 5 and 10 years in the Department of Clinical Neurophysiology, Huddinge University Hospital, Sweden. At diagnosis and before complete remission of the diabetes, abnormal values were found in 25% of patients for motor conduction velocity and sensory nerve action potentials (SNAP) in the median nerve, for sensory conduction velocity and SNAP in the sural nerve, for parasympathetic autonomic function assessed by R-R intervals in the ECG, and for renal function evaluated by glomerular filtration rate. During long-term follow-up, an initial improved sensory nerve conduction was followed after 2 years by deteriorations in sensory and motor nerve conduction and autonomic nerve function. Poor glycemic control correlated with abnormal prolonged nerve conduction. Improved glycemic control by intense insulin treatment reduced the risk of diabetic neuropathy. [1]
COMMENT. Optimal glycemic control of diabetes in children may prevent or delay abnormalities in nerve conduction and autonomic dysfunction and the development of diabetic neuropathy.