Large fibre, small fibre and autonomic neuropathy in adolescents with type 1 diabetes: A systematic review

Vinni Faber Rasmussen; Troels Staehelin Jensen; Hatice Tankisi; Páll Karlsson; Esben Thyssen Vestergaard; Kurt Kristensen; Jens Randel Nyengaard; Astrid Juhl Terkelsen

doi:10.1016/j.jdiacomp.2021.108027

Large fibre, small fibre and autonomic neuropathy in adolescents with type 1 diabetes: A systematic review

J Diabetes Complications. 2021 Nov;35(11):108027. doi: 10.1016/j.jdiacomp.2021.108027. Epub 2021 Aug 18.

Authors

Vinni Faber Rasmussen¹, Troels Staehelin Jensen², Hatice Tankisi³, Páll Karlsson⁴, Esben Thyssen Vestergaard⁵, Kurt Kristensen⁶, Jens Randel Nyengaard⁷, Astrid Juhl Terkelsen⁸

Affiliations

¹ Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Paediatrics, Randers Regional Hospital, Randers, Denmark. Electronic address: vfr@clin.au.dk.
² Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; International Diabetic Neuropathy Consortium, Aarhus University, Denmark.
³ Department of Neurophysiology, Department of Clinical Medicine, Aarhus University, Denmark.
⁴ Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Core Centre for Molecular Morphology, Section for Stereology and Microscopy, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
⁵ Department of Paediatrics, Randers Regional Hospital, Randers, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Denmark.
⁶ Steno Diabetes Center Aarhus, Aarhus University Hospital, Denmark.
⁷ Core Centre for Molecular Morphology, Section for Stereology and Microscopy, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.
⁸ Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.

PMID: 34429229
DOI: 10.1016/j.jdiacomp.2021.108027

Abstract

Aims: To estimate the prevalence of neuropathy in adolescents with type 1 diabetes.

Methods: Systematic collection of published studies exploring the prevalence of large fibre neuropathy (LFN), small fibre neuropathy (SFN), and autonomic neuropathy in adolescents with type 1 diabetes. Following prospective registration (Prospero CRD42020206093), PubMed, EMBASE, and Cochrane Library were searched for studies from 2000 to 2020. PICO framework was used in the selection process (Population: adolescents aged 10-19 years with type 1 diabetes; Intervention: diagnostic methods for neuropathy; Comparison: reference data; Outcome: data on prevalence or comparison). Data were extracted concerning study quality based on available data and established methods for determining and diagnosing various neuropathy types.

Results: From 2,017 initial citations, 27 studies (7589 participants) fulfilled eligibility criteria. The study population (47% males) had a diabetes duration between 4.0 and 10.6 years, and HbA1c level between 7.3 and 10.8%, 56-95 mmol/mol. The prevalence of LFN, based on nerve conduction studies, was 10-57%. Based on other tests for neuropathy, the prevalence of LFN and SFN was 12-62%, and that of cardiac autonomic neuropathy was 12-75%.

Conclusion: The described prevalence of neuropathy in adolescents with type 1 diabetes varied, which can be methodological due to different screening methods and classifications of neuropathy.

Keywords: Adolescents; Neuropathy; Type 1 diabetes.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Adolescent
Diabetes Mellitus, Type 1* / epidemiology
Diabetic Neuropathies / diagnosis
Diabetic Neuropathies / epidemiology*
Female
Humans
Male
Peripheral Nervous System Diseases* / diagnosis
Peripheral Nervous System Diseases* / epidemiology
Prevalence
Prospective Studies