Nerve Conduction Velocity (NCV) Study in Type 2 Diabetes Mellitus Patients to Evaluate Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy is the most commonly reported long term complication of Type 2 Diabetic patients. The sensory symptoms and signs are more common than motor symptoms and signs.

To study and compare the Nerve Conduction study in type 2 Diabetes Mellitus patients with symptomatic and asymptomatic peripheral neuropathy.

This study was conducted in 100 patients of type 2 Diabetes Mellitus age > 18 years. Sample size was divided in 50 symptomatic and 50 asymptomatic patients. The diagnosis of diabetes was based on the criteria given by the national Diabetes Data Group and World Health Organization. Each patient was questioned systematically with regard to symptoms of neuropathy and the areas of limbs involved. A full scale clinical examination, including a detailed neurological examination was done. A complete NCS was done for those patients, using a EMG/NCV/EP ALERON 201, 2 channel machine manufactured by RMS using the standard protocols and settings. Both motor conduction and sensory conduction studies were done with respect to latency, amplitude and velocity.

Out of 100 patients studied, maximum number of cases (36%) observed were in age group of 51–60 years followed by in the age group 41–50 years (27%). The minimum age was 30 years and the maximum age observed was 70 years with ratio of M: F ≍ 2.33: 1. The peripheral neuropathy can be the 1presentation of type 2 diabetes mellitus patients. Most common symptoms were sensory i.e. tingling and burning sensation and the most common sign was the loss of vibration sense. In our study lower limbs affected more than upper limbs. The increased duration of diabetes, higher blood sugar levels and patients who were taken OHA's only were found to have more abnormal results by the Nerve Conduction Studies.

Nerve Conduction Velocity Study is more sensitive tool to detect the presence of neuropathy in diabetics especially in asymptomatic patients and the most common type of peripheral neuropathy detected is axonal sensory motor type neuropathy. The earliest change is the axonal degeneration that is the main pathology in diabetic peripheral neuropathy.