Low Peripheral Nerve Conduction Velocities and Amplitudes Are Strongly Related to Diabetic Microvascular Complications in Type 1 Diabetes The EURODIAB Prospective Complications Study

OBJECTIVE - Slow nerve conduction velocity and reduction in response amplitude are objective hallmarks of diabetic sensonmotor polyneuropathy Because subjective or clinical indicators of neuropathy do not always match well with the presence of abnormal nerve physiology tests we evaluated associations to nerve conduction in patients with type 1 diabetes

RESEARCH DESIGN AND METHODS - Nerve conduction studies were performed in the distal sural and ulnar sensory nerves and the peroneal motor nerve in 456 individuals with type 1 diabetes who participated in the follow up visit of the EURODIAB Prospective Complications Study (EPCS) We used multivariate regression models to describe associations to de creased nerve conduction measures

RESULTS - In addition to an effect of duration of diabetes and AlC which were both associated with low nerve conduction velocity and response amplitude we found that the presence of nephropathy retinopathy or a clinical diagnosis of neuropathy was associated with low nerve conduction velocity and amplitude In the case of nonproliferative retinopathy the odds ratio (OR) for being in lowest tertile was 2 30 (95% CI 1 13-4 67) for nerve conduction velocity A similar OR was found for each 2% difference in AlC (2 39 [1 68-3 41])

CONCLUSIONS - We show that the presence of other microvascular diabetes complications together with diabetes duration and AlC are associated with low nerve conduction velocity and amplitude response and that cardiovascular disease or risk factors do not seem to be associated with these measures