By: Miranda Schwartz
The longer an individual has diabetes, the greater the probability of developing neuropathy. Neuropathy, or nerve damage, is experienced in many ways including: pain in hands and feet, trouble with digestion, loss of sensation and weak muscles.
Neuropathy progresses slowly and, if detected early enough, can be avoided or reversed with good metabolic control.
An early sign of neuropathy is reduced nerve conduction or vibration perception thresholds (VPTs), which have been detected in children with diabetes, say researchers E.A. Davis, FRACP, T.W. Jones, FRACP, et al. According to their article in September’s Diabetes Care, 82 percent of the diabetic children they studied had neurophysiological evidence of the presence of neuropathy without outwardly displaying signs of the disease.
While neuropathy in children is rare, researchers found that nerve conduction abnormalities happen within a year of being diagnosed with type 1. In fact, children as young as 11 were found to have abnormal vibration perception thresholds.
Researchers used a handheld biothesiometer to test nerve conduction in children with diabetes ages 13 to 18 and in children without diabetes ages seven to 18. The biothesiometer delivered small amounts of voltage felt as vibrations in the subjects’ feet. The children responded when they felt vibrations.
Compared to children without diabetes, diabetic children had significantly decreased vibration perception and began to feel the voltage at higher levels than the children without diabetes.
The results of this experiment provide enough data to determine reference ranges for VPT testing in children. Height proved to be the most reliable variable and had the best relationship with VPTs. While the relevance of height to reduced vibration perception is not fully explained, it is important to note that the taller a child is, the higher the VPT. Other neurophysiological studies support that height is inversely and significantly related to lower-limb motor velocity.
This experiment, researchers conclude, indicates that routine neuropathy screening using the non-invasive biothesiometer would be beneficial for children with diabetes. A height-related reference range could make neuropathy screening more practical for young patients and help track its development over time.