Early Involvement of Central Nervous System in type I Diabetic Patients
- Giuseppe Bax, MD,
- Stefania Lelli, MD,
- Umberto Grandis, MD,
- Anna Maria Cospite, MD,
- Negrin Paolo, MD and
- Domenico Fedele, MD
- Department of Internal Medicine, Padova University Padua, Italy
- Electromyographic Service Neurology Department, Padova University Padua, Italy
- Address correspondence and reprint requests to Domenico Fedele, MD, Universita di Padova, Istituto di Medicina Interna, Cattedra di Malattie del Metabolismo, via Vandramini, 7, 35137 Padua, Italy.
Abstract
OBJECTIVE To investigate whether the asymptomatic involvement of the central and peripheral nervous systems may be an early complication of diabetes.
RESEARCH DESIGN AND METHODS We studied early impairment of the central and peripheral nervous system pathways in 15 type I diabetic patients with good metabolic control and short disease duration and in 10 healthy control subjects using a set of neurophysiological tests.
RESULTS Results in diabetic subjects showed 1) impairment of motor (7% and somatosensory (13%) pathways of the central nervous system, 2) impairment of motor and sensory conduction velocities (40–60%), and 3) normal values of the vibration perception threshold and cardiovascular autonomic tests.
CONCLUSIONS The damage is more evident in peripheral sites where hyperglycemia and aldose reductase pathways are more active. Instead, several episodes of hypoglycemia, which occur in type I diabetic patients in good metabolic control, may cause alterations of brain nervous cells.
- Received December 21, 1993.
- Revision received September 1, 1994.
- Accepted September 1, 1994.
- Copyright © 1995 by the American Diabetes Association
