Introduction The prevalence of neuropathic lesions in young patients with type 1 diabetes mellitus (T1DM) at the time of transition from pediatric care to adult-oriented diabetes care is poorly studied. A comparative study with healthy volunteers to assess the possible neuropathic condition of this special population and to identify the potential early screening needs has not been performed yet. The results may provide important feedback to pediatric diabetes care and a remarkable baseline reference point for further follow up in adult diabetes care. Patients and Methods Twenty-nine young patients with T1DM [age: 22.4 ± 2.9 years; HbA1c: 8.5 ± 2.1%, diabetes duration: 12.2 ± 5.8 years; (mean ± SD)] and 30 healthy volunteers (age: 21.5 ± 1.6 years; HbA1c: 5.3 ± 0.3%) were involved in the study. Autonomic function was assessed by standard cardiovascular reflex tests. Complex peripheral neuropathic testing was performed by Neurometer®, Neuropad®-test, Tiptherm®, Monofilament®, and Rydel-Seiffer tuning fork tests. Results T1DM patients had significantly higher diastolic blood pressure than controls (80 ± 9 vs. 74 ± 8 mmHg, p < 0.01), but there was no significant difference in systolic blood pressure (127 ± 26 vs. 121 ± 13 mmHg). Cardiovascular reflex tests had not revealed any significant differences between the T1DM patients and controls. No significant differences with Neurometer®, Neuropad®-test, and Monofilament® were detected between the two groups. The vibrational sensing on the radius on both sides was significantly impaired in the T1DM group compared to the controls with Rydel-Seiffer tuning fork test (right: 7.5 ± 1.0 vs. 7.9 ± 0.3; left: 7.5 ± 0.9 vs. 7.9 ± 0.3, p < 0.05). The Tiptherm®-test also identified a significant impairment in T1DM patients (11 sensing failures vs. 1, p < 0.001). In addition, the neuropathic complaints were significantly more frequently present in the T1DM patient group than in the controls (9 vs. 0, p < 0.01). Conclusion In this young T1DM population, cardiovascular autonomic neuropathy and cardiac morphological alterations could not be found. However, Rydel-Seiffer tuning fork and Tiptherm®-tests revealed peripheral sensory neurological impairments in young T1DM patients at the time of their transition to adult diabetes care.

中文翻译：

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从儿科护理过渡到成人糖尿病护理时年轻 1 型糖尿病患者的周围和自主神经病变状态。

简介 在从儿科护理过渡到以成人为导向的糖尿病护理期间，年轻 1 型糖尿病 (T1DM) 患者的神经病变患病率研究很少。尚未进行与健康志愿者进行的比较研究，以评估这一特殊人群可能的神经病变状况并确定潜在的早期筛查需求。该结果可能为儿科糖尿病护理提供重要反馈，并为成人糖尿病护理的进一步跟进提供显着的基线参考点。患者和方法 29 名年轻的 T1DM 患者 [年龄：22.4 ± 2.9 岁；HbA1c：8.5 ± 2.1%，糖尿病病程：12.2 ± 5.8 年；(mean ± SD)] 和 30 名健康志愿者（年龄：21.5 ± 1.6 岁；HbA1c：5.3 ± 0.3%）参与了研究。通过标准心血管反射测试评估自主神经功能。通过 Neurometer®、Neuropad®-test、Tiptherm®、Monofilament® 和 Rydel-Seiffer 音叉测试进行复杂的周围神经病变测试。结果 T1DM 患者的舒张压显着高于对照组（80 ± 9 vs. 74 ± 8 mmHg，p < 0.01），但收缩压无显着差异（127 ± 26 vs. 121 ± 13 mmHg）。心血管反射测试未发现 T1DM 患者和对照组之间有任何显着差异。在两组之间检测到 Neurometer®、Neuropad®-test 和 Monofilament® 没有显着差异。与使用 Rydel-Seiffer 音叉测试的对照组相比，T1DM 组两侧半径的振动感应显着受损（右：7.5 ± 1.0 vs. 7. 9±0.3；左：7.5 ± 0.9 与 7.9 ± 0.3，p < 0.05）。Tiptherm®-测试还确定了 T1DM 患者的显着损伤（11 次感应失败对 1 次，p < 0.001）。此外，与对照组相比，T1DM 患者组的神经病变主诉明显更频繁（9 对 0，p < 0.01）。结论 在这一年轻的 T1DM 人群中，未发现心血管自主神经病变和心脏形态学改变。然而，Rydel-Seiffer 音叉和 Tiptherm® 测试揭示了年轻 T1DM 患者在过渡到成人糖尿病护理时的周围感觉神经损伤。与对照组相比，T1DM 患者组的神经病变主诉明显更频繁（9 对 0，p < 0.01）。结论 在这一年轻的 T1DM 人群中，未发现心血管自主神经病变和心脏形态学改变。然而，Rydel-Seiffer 音叉和 Tiptherm® 测试揭示了年轻 T1DM 患者在过渡到成人糖尿病护理时的周围感觉神经障碍。与对照组相比，T1DM 患者组的神经病变主诉明显更频繁（9 对 0，p < 0.01）。结论 在这一年轻的 T1DM 人群中，未发现心血管自主神经病变和心脏形态学改变。然而，Rydel-Seiffer 音叉和 Tiptherm® 测试揭示了年轻 T1DM 患者在过渡到成人糖尿病护理时的周围感觉神经障碍。