The connection between metabolic control, length of illness and neuropathy in children and adolescents with T1 Diabetes Short title: Metabolic control and neuropathy in children with T1 Diabetes
Background. Diabetic neuropathy is a clinical or sub-clinical disorder in type 1 diabetes mellitus (T1DM) in the absence of any other causes for peripheral neuropathy. Methods. This one-year study comprised 69 subjects, children and adolescents with T1DM. The metabolic control of the illness was assessed on the basis of the glycaemia, glycosylated haemoglobin, lipid status, blood pressure, body weight and height and body mass index of the subjects. The data from a questionnaire assessed the frequency of clinical signs of diabetic neuropathy. Results. The clinical manifestations of diabetic neuropathy were muscular weakness, cramps, paraesthesia, insensitivity to pain, vomiting, diarrhoea, urinary disorders. The subjects with neuropathy had glycaemia of 9.8±1.8 mmol/L and HbA1C 10.6 ± 2.2%, with statistically significantly increased triglyceride levels (t=1.8, p=0.04), systolic and diastolic blood pressure (t=5.4, p <0.001; t=6.4 p<0.001) and BMI (t=2.0, p=0.05). The subjects with T1DM>10 years had significantly more frequent pathological findings of the back of the eye (X2=3,2, p=0,02), with no statistically significant difference in albumin/creatinine (urine). The ROC curve with an analysis of age at the beginning of neuropathy was 11.7 years, with 55% sensitivity and 82% specificity. Conclusion. Our analysis suggests that there is a significant connection between the metabolic condition and the duration of the illness and the increased frequency of neuropathy in children and adolescents with T1DM. Aim. To test the hypothesis that metabolic control and length of illness are connected with an increased frequency of neuropathy in children and adolescents with T1DM.