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Peripheral neuropathy is an early complication of type 2 diabetes in adolescence

Shield, Julian P.H.; Ryan, Fiona J.; Crowne, Elizabeth C.; Karabouta, Zacharoula; Barnett, Susan

Authors

Julian P.H. Shield

Fiona J. Ryan

Elizabeth C. Crowne

Zacharoula Karabouta



Abstract

Objective: To screen for microvascular complications in adolescents with type 2 diabetes mellitus (T2DM). Subjects and methods: Seven adolescents with T2DM were assessed for early secondary complications. Median duration of diabetes was 1.8 (0.8-3.0)yr. All were assessed as follows: blood pressure, ophthalmologic examination for diabetic retinopathy, renal function, full blood count and vitamin B12 levels (to exclude B12 malabsorption - a side effect of metformin), random urine for microalbuminuria, an electrocardiogram (ECG) rhythm strip and podiatry performed by an experienced podiatrist. Testing for peripheral neuropathy included foot pulse palpation, tendo-Achilles reflexes, plantar callus test, large nerve fibre function (vibration and threshold for light touch/pressure) assessed by a 128-Hz tuning fork, and by the standard 10-g Semmes-Weinstein monofilament test, and small nerve fibre function (pain) assessed by pinprick neurotip. Results: Four adolescents had evidence of peripheral neuropathy on clinical examination, with abnormal large and small nerve fibre function. Six had plantar callus present, and four had weak but palpable posterior tibial pulses. All had normal tendo-Achilles reflex and normal response to vibration. None had diabetic retinopathy or hypertension. Renal function, full blood count (FBC), B12 levels and ECGs were normal. None of 120 adolescents with type 1 diabetes mellitus (T1DM) assessed by the same podiatrist had any signs of peripheral neuropathy. Conclusions: Unlike T1DM, peripheral neuropathy can be present soon after diagnosis in those with T2DM. Children with T2DM need surveillance for complications from the time of diagnosis. © 2008 The Author Journal compilation © 2008 Blackwell Munksgaard.

Citation

Crowne, E. C., Ryan, F. J., Shield, J. P., Karabouta, Z., & Barnett, S. (2008). Peripheral neuropathy is an early complication of type 2 diabetes in adolescence. Pediatric Diabetes, 9(2), 110-114. https://doi.org/10.1111/j.1399-5448.2007.00339.x

Journal Article Type Article
Publication Date Apr 1, 2008
Journal Pediatric Diabetes
Print ISSN 1399-543X
Electronic ISSN 1399-5448
Publisher Wiley
Peer Reviewed Not Peer Reviewed
Volume 9
Issue 2
Pages 110-114
DOI https://doi.org/10.1111/j.1399-5448.2007.00339.x
Keywords adolescents, peripheral neuropathy, T2DM
Public URL https://uwe-repository.worktribe.com/output/1013663
Publisher URL http://dx.doi.org/10.1111/j.1399-5448.2007.00339.x