O-51: Peripheral nerve conduction in youth with type 1 diabetes: longitudinal analysis of clinical and CGM predictors
B Bombaci, G Salzano, S Aramnejad, F Macrì, L Faranna, A Alibrandi, V Rizzo, F Luppino, F Lombardo, S PassanisiAbstract
Introduction
Diabetic peripheral neuropathy (DN) in youth with type 1 diabetes (T1D) is often subclinical and remains underexplored.
Objectives
We aimed to describe nerve conduction study (NCS) findings in a pediatric T1D cohort and to identify clinical and continuous glucose monitoring (CGM) predictors.
Methods
In this single-center, longitudinal, observational study, 207 children and adolescents with T1D underwent lower-limb NCS, assessing peroneal motor conduction velocity (MCV) and compound muscle action potential (CMAP), and sural sensory conduction velocity (SCV) and sensory nerve action potential (SNAP). Clinical and metabolic data, 5-year HbA1c patterns (mean and standard deviation), and 2-year CGM metrics were analyzed with multivariable generalized linear models. Logistic regression assessed predictors of 2-year NCS deterioration.
Results
Older age was associated with lower peroneal MCV (B=−0.59; p=0.001). Male sex predicted preserved CMAP values (B=2.04; p=0.030). Higher 5-year mean HbA1c correlated with reduced CMAP (B=−3.72; p<0.001). No predictors emerged for sural SCV or SNAP. Longitudinally, higher mean sensor glucose increased the odds of peroneal MCV decline (OR=1.13; p=0.025), and longer diabetes duration predicted SNAP deterioration (OR=1.32; p=0.021) (Figure).
Conclusions
NCS detects early large-fiber abnormalities consistent with DN in pediatric T1D. Motor parameters appear to be affected first and relate to cumulative glycemic exposure, whereas sensory axonal involvement may be linked to longer disease duration. Youth with sustained suboptimal glycemic control should be considered at higher risk for subclinical DN. Incorporating NCS into follow-up may allow timely detection and targeted prevention in this population.