Sympathetic skin response may detect and predict prognosis of diabetic peripheral neuropathy in children
T1DM, the most common subtype of pediatric diabetes mellitus, is increasing at around 3%. Genetic and environmental factors (eating habits, physical inactivity and pollution) are speculated to be involved in the pathogenesis of T1DM. These factors make the management of diabetes complicated. To establish the diagnosis and prognosis of many diseases, sympathetic skin response (SSR) has been used to evaluate the autonomic unmyelinated nerve fibre function. SSR could provide the accurate early diagnosis and follow-up of pediatric diabetic peripheral neuropathy, says Mei Jin in a recent study published in BMC Pediatrics.
The morbidity of T1DM in children is increasing, and diabetic peripheral neuropathy (DPN) is the main microvascular complication of T1DM. Considering this, researchers explored SSR characteristics in children with T1DM and analyzed the value of early diagnosis and follow-up in T1DM complicated with DPN.
The study enrolled 85 participants with T1DM and 30 healthy controls (HCs) in the Children’s Hospital of Hebei Province ( 2017 to 2020). Key findings of the study are:
- SSR latency of the T1DM group showed a statistical difference compared to HCs.
- The SSR test was more sensitive in diagnosing T1DM with DPN early than the nerve conduction study (NCS) test.
- The abnormal rates of SSR and NCS during the long duration of the disease were higher than those in the short duration.
- Among 65 participants with diabetic neuropathy, the onset latencies of SSR were shortened, and the NCS were improved after treatment.
SSR and NCS could play a prominent role in screening for the development of DPN. SSR and NCS could evaluate and assess the small unmyelinated sympathetic fibres and large myelinated peripheral nerves, respectively and are well-tolerated by children.
They said SSR could provide an accurate early diagnosis and follow-up of neuropathy as these tests are superior to NCS tests in diagnosing neuropathy early.
Reference:
Jin, M., Liu, J., Liu, K. et al. Evaluation of sympathetic skin response for early diagnosis and follow-up of diabetic peripheral neuropathy in children. BMC Pediatr 23, 483 (2023). https://doi.org/10.1186/s12887-023-04323-4
