Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 16;59(3):197-200.
doi: 10.29399/npa.27952. eCollection 2022.

The First Electrophysiological Abnormality in New-onset DM: Autonomic Tests

Zülfikar Memiş  1 , Nihat Çevik  2 , Hürtan Acar  1 , Sefer Günaydin  1 , Özlem Çokar  1
Affiliations

The First Electrophysiological Abnormality in New-onset DM: Autonomic Tests

Zülfikar Memiş et al. Noro Psikiyatr Ars. .

Abstract

Introduction: Conventional nerve conduction studies (NCS) are used in the electrodiagnosis of diabetic neuropathy. The aim of our study was to investigate diabetic small fiber neuropathy in newly diagnosed type 2 diabetes mellitus (DM) patient group by using autonomic tests.

Methods: Our study was conducted on 49 patients (24 female, 25 male) who were newly diagnosed with type 2 DM in the last 3 months and a control group of 25 volunteers. In addition to conventional NCS, sympathetic skin response (SSR) and RR interval variability (RRIV) tests were performed.

Results: The mean upper limb SSR latency of the patient group was more prolonged than that of the control group, whereas the mean lower limb SSR amplitude of the patient group was lower than that of the control group (p=0.002, p<0.001; respectively). The mean resting (R) and deep inspiration (D) RRIV values of the patient group were lower than that of the control group (p=0.037, p<0.001; respectively). In the patient group, the mean R-RRIV and D-RRIV values were found to be positively correlated with the lower limb SSR amplitude (r=0.006, r=0.011; respectively). The mean R-RRIV and D-RRIV change rate of the patient group (D-R)/R was found to be lower than that of the control group (p=0.002).

Conclusion: In our study, we showed that autonomic function tests were impaired in newly diagnosed type 2 DM patients who were found not to have diabetic polyneuropathy by standard electrophysiological study. These findings suggest that standard electrophysiological tests are not sufficient in the early stages of the disease.

Keywords: Neuropathy; RR interval variability; autonomic nervous system; diabetes mellitus; sympathetic skin response.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: There is no conflict of interest between any institution, organization, person and authors related to our article.

References

    1. Izenberg A, Perkins BA, Bril V. Diabetic Neuropathies. Semin Neurol. 2015;35:424–430. - PubMed
    1. Khoshnoodi MA, Truelove S, Burakgazi A, Hoke A, Mammen AL, Polydefkis M. Longitudinal Assessment of Small Fiber Neuropathy:Evidence of a Non-Length-Dependent Distal Axonopathy. JAMA Neurol. 2016;73:684–690. - PubMed
    1. Kittnar O. Electrocardiographic changes in diabetes mellitus. Physiol Res. 2015;64(Suppl 5):559–566. - PubMed
    1. Tunalı G, Bebek Yılmaz Z, Bek Y. Distal Simetrik Nöropati TanısıAlmışDiyabetik Hastalarda Otonom Nöropatinin Klinik ve Elektrofizyolojik Testler ile Araştırılması. Turkiye Klinikleri J Med Sci. 2014;34:152–164.
    1. Greaney JL, Kenney WL. Measuring and quantifying skin sympathetic nervous system activity in humans. J Neurophysiol. 2017;118:2181–2193. - PMC - PubMed

LinkOut - more resources