Clinical and Electrophysiological evaluation of patients with diabetic Neuropathy

Abstract

Diabetic neuropathy (DN) is one of the most common and debilitating complications of diabetes mellitus, affecting nearly half of all individuals with long-standing diabetes. It is a progressive disorder resulting from chronic hyperglycemia, oxidative stress, and microvascular dysfunction, leading to structural and functional damage of peripheral nerves. The condition manifests in various forms, including distal symmetric polyneuropathy (DSPN), autonomic neuropathy, and focal neuropathies, each with distinct clinical and pathophysiological features. Early detection and accurate evaluation of diabetic neuropathy are crucial for timely intervention and management.To study types of neuropathy in Type 2 diabetes and to study the Neurophysiologic patterns in each type of Diabetic Neuropathy and the extent of their clinical correlation.A hospital-based cross-sectional study was conducted in the Department of General Medicine in V.M.K.V. MEDICAL COLLEGE HOSPITAL from January 2024 to November 2024. A total of 150 Type II diabetic patients with a minimum 5-year duration of diabetes will be selected from Vinayaka Mission Kirupananda Variyar Medical College and Hospital Salem for the study. Determination of whether a patient had neuropathy was based on review of the medical record, neurologic tests including bed side autonomic function tests, nerve conduction (NC) abnormalities. Sensorimotor polyneuropathy was the most common form of peripheral neuropathy (58.7%), followed by mixed type peripheral neuropathy (29.3%) and Autonomic Neuropathy (AN) (12.0%). Regarding the grades of diabetic neuropathy, 47.4% had grade 2 diabetic neuropathy, 31.3% had grade 1 and 12.0% ha\d grade 3 diabetic neuropathy.The clinical and electrophysiological evaluation of diabetic neuropathy provides a comprehensive understanding of disease severity, progression, and prognosis. While clinical assessment identifies symptomatic and functional impairments, electrophysiological studies objectively confirm neuropathy, assess nerve damage, and help rule out other causes of neurpaothy.