Turkish Research

A short post from me this morning… I was doing a little research yesterday, and stumbled across reference to this article:

Peripheral neuropathy in children with insulin dependent
diabetes mellitus

Fiçicioğlu C, Aydin A, Haktan M, Kiziltan M.
Istanbul University Cerrahpa şa Faculty of Medicine.
Turk J Pediatr. 1994 Apr-Jun;36(2):97-104. (Link)

Peripheral somatic nerve function was studied in 38 unselected diabetic children and 31 age and sexmatched
healthy controls. Thirteen of the 38 diabetics had abnormal peripheral somatic nerve function tests (more than 3 SD below the mean for normals). Five of the 13 diabetic children had only abnormal peripheral nerve function (early asymptomatic neuropathy); seven of these 13 were abnormal both in neurologic examination and peripheral nerve function (asymptomatic neuropathy). Only one of the 13 patients showed neuropathic symptoms as well as an abnormal neurologic examination and impaired peripheral nerve function tests (symptomatic neuropathy). Both motor and sensory peripheral somatic nerve abnormalities were related to poor glycemic control (HbA1c) and duration of diabetes. Individual peripheral nerve tests correlated with HbA1c (fibular motor, p < 0.001; sural sensory, p < 0.05) or duration of diabetes (fibular motor, p < 0.01; median motor, p < 0.01). These results emphasize the importance of metabolic control and duration of diabetes in the pathogenesis of diabetic neuropathy. The findings suggest that peripheral neuropathy is common in young, insulin dependent diabetics. Being easy to conduct and sensitive, regular followup of nervous function test results may help to achieve good metabolic control and prevent diabetic complications.

In other words, of 38 randomly selected Type-1 diabetic children, ONE THIRD had some degree of Neuropathy. If your doctor doesn’t believe you that children can have it, print out this blog post and take it with you.

If anyone has access to the Turkish Journal of Paediatrics, I would be very greatful for a full version of this article, my University only has back to 2002.

With love and jelly-babies,

Janek xx


3 Responses so far »

  1. 1

    Phyllis said,

    The University of Cincinnati has this journal in their storage depository and it is possible that I would be able to get a photocopy of it sent to me that I could then forward to you. The request might take a couple of weeks or more. If you’re still looking for a copy, please email me.

  2. 2

    Britt said,

    Hey Janek, this article acknowledges the presence of neuropathy in children, the references may lead somewhere. Email me if you want the full article.

    Please send my best to Kate and Lance

    The following is copied from the first page of the article.
    Pediatric Diabetes 2006: 7: 305–310
    All rights reserved
    # 2006 The Authors
    Journal compilation # 2006 Blackwell Munksgaard
    Pediatric Diabetes
    Original Article
    Comparison of conventional and non-invasive
    techniques for the early identification of
    diabetic neuropathy in children and
    adolescents with type 1 diabetes
    Nelson D, Mah JK, Adams C, Hui S, Crawford S, Darwish H, Stephure
    D, Pacaud D. Comparison of conventional and non-invasive techniques
    for the early identification of diabetic neuropathy in children and
    adolescents with type 1 diabetes.
    Pediatric Diabetes 2006: 7: 305–310.
    Background: Neuropathy is an important complication and contributes
    to the morbidity of diabetes mellitus. The availability of simple and noninvasive
    tests for screening of early diabetic neuropathy (DN) in children
    with diabetes may prevent further progression of this complication. The
    purpose of this study was to compare conventional nerve conduction
    studies (NCS) with non-invasive techniques, including vibration perception
    thresholds (VPT) and tactile perception thresholds (TPT) for the
    detection of DN in children and adolescents with type 1 diabetes.
    Methods: Children from the Alberta Children’s Hospital Diabetes Clinic
    with at least 5 yr duration of type 1 diabetes underwent detailed
    evaluations, including neurologic exam, NCS, VPT, and TPT testing.
    Information on duration of diabetes, height, and mean glycosylated
    hemoglobin (A1C) were also collected. Descriptive statistics, including
    Student’s t-test and chi-squared test, were used for analysis.
    Results: Seventy-three children (mean age of 13.7  2.6 yr) completed the
    study. Themean duration of diabeteswas 8.12.6 yr, and themeanA1Cwas
    9.0 1.0%. Forty-two (57%) children hadDNbased onNCS.UsingNCS as
    a gold standard, the sensitivity and specificity of VPT were 62 and 65%, while
    the sensitivity and specificity of TPT were 19 and 64%, respectively.
    Conclusions: Subclinical DN is common among children and adolescents
    with type 1 diabetes, and there is a need for better metabolic control in this
    population. VPT and TPT may not be adequate screening tools for the
    detection of DN in children.

  3. 3

    Jan said,

    I do know one-third of Type 1 patients will eventually have some form of kidney disease or 30 percent; that is very high. As parents, we are told we can, most likely, with diligent care, prevent complications. I don’t believe that. Interesting that there is such a high incidence of peripheral neuropathy. I wonder if 30 percent is the norm for each of the complications? I still think your only hope is finding an adult endo who specializes in treating peripheral neuropathy, as I do believe what you are saying, that pediatric endos deny even the possibility of this complication, among others. If you have never even seen a case of peripheral neuropathy, how can you properly diagnose it? Praying that there is a medical specialist that will help this young child and stop adding to the Mom’s stress by playing mental mind games. There has got to be someone out there that can help.

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