Prevalence of subclinical neuropathy in Northern Sardinian adolescents with type 1 diabetes: results of an electrophysiological and clinical screening

Introduction. Diabetic neuropathy (DN) is a common complication of type 1 diabetes (T1DM). DN may affect both the peripheral and autonomic nervous system and is classified on the basis of the site of the lesion, type of nervous fibres involved, and presence of clinical signs and/or electrophysiological abnormalities. The pathogenesis of DN is still unclear, but several mechanisms are believed to play a role: ischemic damage, the metabolic effects of hyperglycemia, autoimmunity. Methods. In order to assess the prevalence of neuropathy we evaluated by means of clinical and electrophysiological examination 53 patients from Northern Sardinia, affected by T1DM. Results. Electrophysiological signs of neurological impairment were observed in 38 of them. A significant positive correlation between electrophysiological abnormalities, duration of diabetes and levels of glycated haemoglobin was found. Discussion. This preliminary study showed that subclinical neurological impairment is a common complication in patients with T1DM. The presence of autoantibodies to autonomic nervous tissue structures at the onset of the disease, their reduction along with a good metabolic control and their reappearance with the neurological involvement, support the hypothesis of an autoimmune condition. Investigations on the immunological patterns of our patients are scheduled to try to better assess the pathogenesis of DN.