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1 "Joong Hyun Park"
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Original Article
Complications
Patterns of Nerve Conduction Abnormalities in Patients with Type 2 Diabetes Mellitus According to the Clinical Phenotype Determined by the Current Perception Threshold
Joong Hyun Park, Jong Chul Won
Diabetes Metab J. 2018;42(6):519-528.   Published online October 24, 2018
DOI: https://doi.org/10.4093/dmj.2018.0068
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  • 15 Web of Science
  • 12 Crossref
AbstractAbstract PDFPubReader   
Background

Clinical manifestations of diabetic peripheral neuropathy (DPN) vary along the course of nerve damage. Nerve conduction studies (NCS) have been suggested as a way to confirm diagnoses of DPN, but the results have limited utility for evaluating clinical phenotypes. The current perception threshold (CPT) is a complementary method for diagnosing DPN and assessing DPN symptoms. We compared NCS variables according to clinical phenotypes determined by CPT measurements.

Methods

We retrospectively enrolled patients with type 2 diabetes mellitus who underwent both NCS and CPT tests using a neurometer. CPT grades were used to determine the clinical phenotypes of DPN: normoesthesia (0 to 1.66), hyperesthesia (1.67 to 6.62), and hypoesthesia/anesthesia (6.63 to 12.0). The Michigan Neuropathy Screening Instrument (MNSI) was used to determine a subjective symptom score. DPN was diagnosed based on both patient symptoms (MNSI score ≥3) and abnormal NCS results.

Results

A total of 202 patients (117 men and 85 women) were included in the final analysis. The average age was 62.6 years, and 71 patients (35.1%) were diagnosed with DPN. The CPT variables correlated with MNSI scores and NCS variables in patients with diabetes. Linear regression analyses indicated that hypoesthesia was associated with significantly lower summed velocities and sural amplitudes and velocities, and higher summed latencies, than normoesthesia. Sural amplitude was significantly lower in patients with hyperesthesia than in patients with normoesthesia.

Conclusion

NCS variables differed among patients with diabetes according to clinical phenotypes based on CPT and decreased sural nerve velocities was associated with hyperesthesia.

Citations

Citations to this article as recorded by  
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    R Kartheka, Rajeswari Aghoram, A Joel Faith, Vaibhav Wadwekar
    Annals of Indian Academy of Neurology.2024; 27(2): 183.     CrossRef
  • Evoked sensations with transcutaneous electrical stimulation with different frequencies, waveforms, and electrode configurations
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    Artificial Organs.2023; 47(1): 117.     CrossRef
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    Journal of Korean Foot and Ankle Society.2022; 26(4): 177.     CrossRef
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  • New Perspective in Diabetic Neuropathy: From the Periphery to the Brain, a Call for Early Detection, and Precision Medicine
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    Diabetes & Metabolism Journal.2020; 44(4): 542.     CrossRef
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    Journal of Diabetes Research.2020; 2020: 1.     CrossRef
  • Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention
    Dinesh Selvarajah, Debasish Kar, Kamlesh Khunti, Melanie J Davies, Adrian R Scott, Jeremy Walker, Solomon Tesfaye
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