SENSORIMOTOR NEUROPATHY IN TYPE 2 DIABETES MELLITUS A CLINICAL AND ELECTROPHYSIOLOGICAL CORRELATION

Dr. Pradeep T.V; Steffy Kuriakose

Volume : V, Issue : X, October - 2016

SENSORIMOTOR NEUROPATHY IN TYPE 2 DIABETES MELLITUS A CLINICAL AND ELECTROPHYSIOLOGICAL CORRELATION

Dr. Pradeep T. V, Steffy Kuriakose

Abstract :

Background : Diabetic neuropathy(DN)is the most common and troublesome complication of D.M leading to great mortality and morbidity.Both micro and macro vascular predominate mainly due to delayed diagnosis . Hence this study was done for early evaluation of neuropathy with nerve conduction studies. Objectives : 1)To study the clinical and electrophysiological pattern of peripheral neuropathy inType 2 diabetes 2)To determine association of diabetic neuropathy with duration of diabetes. Methods and materials: Cross sectional study done randomly involving 40 cases of Type 2 DM patients with or without symptoms of sensorimotor neuropathy. NCS was done using a EMG EP MARK 2 machine from RECORDER & MEDICARE SYSTEMS. Chi square test is the statistical method used in our study. Results: Out of the 40 patients, 29 were male(72.5%)and 11 were females(27.5%)20 (50%)cases presented with the symptoms of diabetes.13 cases with both diabetes and neuropathy (32.5%) and 7 cases with neuropathy(17.5%).The symptoms include tingling and numbness(100%),burning sensation(25%),weakness in any limbs (15%),cramps in calves/foot, pain in any limbs(20%)and allodynia(5%).Viation sense lost in 17.5%,ankle jerk in 12.5% .20 patients(50.0%)were found to be Symptomatic of neuropathy while 20 patients (50%) were asymptomatic.Major clinical type was distal symmetric sensory neuropathy(85%).The type of nerve damage observed was axonal degeneration(60%)found in symptomatics,while demyelinating type in(40%)More patients were seen in the duration of diabetes for 3–6 years.70% of patients with abnormal reports were on treatment with OHA�s.Majority of the symptomatics (70.0%) were found to be in the OHA`s group. However 2 (10.0%) of the symptomatics were found to be first time detected diabetics who were not on any treatment. Conclusion : Distal peripheral neuropathy presents before the onset of symptoms as demonstrated by NCS in asymptomatic diabetics. Patients with long standing diabetes and OHA�s have higher incidenceof nerve conduction abnormalities.Axonal demyelination was the commonest nerve conduction abnormality which is a length dependent neuropathy can be diagnosed clinically by a monofilament test in resource limited settings.