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Vinni Faber Rasmussen*, Mathilde Thrysøe, Jens Randel Nyengaard, Hatice Tankisi, Páll Karlsson, John Hansen, Klaus Krogh, Christina Brock, Konstantinos Kamperis, Mette Madsen, Wolfgang Singer, Esben Thyssen Vestergaard, Kurt Kristensen, Astrid Juhl Terkelsen
Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review
AIMS: To estimate the prevalence of large fiber (LFN), small fiber (SFN), and autonomic neuropathy in adolescents with type 1 diabetes using confirmatory tests known from adults and to identify risk factors and bedside methods for neuropathy.
METHODS: Sixty adolescents with type 1 diabetes (diabetes duration>five years) and 23 control subjects underwent neurological examination and confirmatory diagnostic tests for neuropathy, including nerve conduction studies, skin biopsies determining intraepidermal nerve fiber density, quantitative sudomotor axon reflex test (QSART), cardiovascular reflex tests (CARTs), and tilt table test. Possible risk factors were analyzed. Bedside tests (biothesiometry, DPNCheck®, Sudoscan, and Vagus®device) were compared with the confirmatory tests using ROC analysis.
RESULTS: The prevalence of neuropathies in the adolescents with diabetes (mean HbA1c 7.6% (60 mmol/mol)) was as follows: 14% confirmed/26% subclinical LFN, 2% confirmed/25% subclinical SFN, 20% abnormal QSART, 8% abnormal CARTs, and 14% orthostatic hypotension. Higher age, higher insulin dose, previous smoking, and higher triglycerides level were found to increase the relative risk for neuropathy. The bedside tests showed poor to acceptable concordance with the confirmatory tests (all, AUC ≤ 0.75).
CONCLUSIONS: The diagnostic tests confirmed the presence of neuropathy in adolescents with diabetes and underscore the importance of prevention and screening.
Original language | English |
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Article number | 110736 |
Journal | Diabetes Research and Clinical Practice |
Volume | 201 |
Number of pages | 9 |
ISSN | 0168-8227 |
DOIs | |
Publication status | Published - Jul 2023 |
Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Corrigendum › Research › peer-review
Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Comment/debate/letter to the editor › Research › peer-review