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Comparison of conventional and non‐invasive techniques for the early identification of diabetic neuropathy in children and adolescents with type 1 diabetes
Author(s) -
Nelson Danielle,
Mah Jean K,
Adams Coleen,
Hui Stephanie,
Crawford Susan,
Darwish Husam,
Stephure David,
Pacaud Danièle
Publication year - 2006
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-5448.2006.00208.x
Subject(s) - medicine , diabetes mellitus , subclinical infection , type 1 diabetes , type 2 diabetes , complication , diabetic neuropathy , population , gold standard (test) , pediatrics , endocrinology , environmental health
Background: Neuropathy is an important complication and contributes to the morbidity of diabetes mellitus. The availability of simple and non‐invasive 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. The mean duration of diabetes was 8.1 ± 2.6 yr, and the mean A1C was 9.0 ± 1.0%. Forty‐two (57%) children had DN based on NCS. Using NCS 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.