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  • Oral presentation
  • Open Access

Sensory neuropathy in young people with type 1 diabetes: a systematic review

  • 1,
  • 2, 3 and
  • 1, 2, 3
International Journal of Pediatric Endocrinology20152015 (Suppl 1) :O34

https://doi.org/10.1186/1687-9856-2015-S1-O34

  • Published:

Keywords

  • Neuropathy
  • Young People
  • Peripheral Neuropathy
  • Sensory Neuropathy
  • Diabetes Duration

Peripheral sensory neuropathy and its risk factors are well-described in adults with type 1 diabetes (T1D). While clinically evident neuropathy is rare in young people with T1D, we and others have shown that subclinical peripheral neuropathy is common [1]. However, the prevalence of sensory neuropathies may be underestimated, due to a lack of established testing guidelines.

We performed a systematic review of the epidemiology of peripheral sensory neuropathy, and diagnostic accuracy of tools used for its assessment, in young people with T1D. We searched Medline and Embase from Jan 1985 to Mar 2014. Inclusion criteria were studies in young people with diabetes duration > 1 year which tested for sensory neuropathy using nerve conduction velocity (NCV), temperature perception threshold (TPT), vibration perception threshold (VPT) and/or clinical examination.

We identified 26 eligible studies, involving 5527 young people with T1D. Only 7/26 (27%) studies were of good methodological quality (Newcastle Ottowa Scale score > 7). Clinical examination yielded a wide variation in the rates of sensory neuropathy, with pooled prevalence of 15% (95% CI 13 to 17). Abnormal VPT was more common, with pooled prevalence 33% (30 to 36), as was TPT, with pooled prevalence 32% (26 to 39). The prevalence of abnormal NCV was similar 36% (33 to 39). Overall, the pooled prevalence of sensory neuropathy, using any test, was 26% (24 to 27). We calculated sensitivity and specificity of the different diagnostic tests that were used in the included studies, in comparison with neuropathies detected by ‘gold standard’ nerve NCV testing. The sensitivity of VPT ranged from 29-62%, and specificity from 65-100%. Sensitivity of TPT was 19% and specificity was 65% (one study). The sensitivity of clinical examination ranged from 0-100% and specificity from 81-100%.

In conclusion, there is marked variation in reported prevalence rates of sensory neuropathy, due to lack of consensus on its definition, classification of abnormal results, and testing methodology. Clinical examination demonstrates the lowest sensitivity for detection of sensory neuropathy in young people with T1D.

Authors’ Affiliations

(1)
School of Women’s and Children’s Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
(2)
Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Sydney, NSW, Australia
(3)
Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW, Australia

References

  1. Downie E, Craig ME, Hing S, Cusumano J, Chan AK, Donaghue KC: . Diabetes Care. 2011, 34 (11): 2368-2373. 10.2337/dc11-0102.PubMed CentralView ArticlePubMedGoogle Scholar

Copyright

© Jayasuriya et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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