Early Electrophysiological Abnormalities and Clinical Neuropathy A prospective study in patients with type 1 diabetes

RESULTSdAt baseline, patients showed modestly reduced nerve conduction velocities and amplitudes compared with healthy subjects, but all were free of clinical neuropathy. At followup, clinical neuropathy was present in nine (15%) patients. These patients had a more pronounced reduction in peroneal motor nerve conduction velocity (MCV), medianMCV, and sural sensory nerve action potential at baseline (P , 0.010–0.003). In simple logistic regression analyses, the predictor with the strongest association with clinical neuropathy was baseline HbA1c (R 2 = 48%, odds ratio 7.9, P , 0.002) followed by peroneal MCV at baseline (R = 38%, odds ratio 0.6, P , 0.006). With the use of a stepwise forward analysis that included all predictors, first baseline HbA1c and then only peroneal MCV at baseline entered significantly (R = 61%). Neuropathy impairment assessment showed a stronger correlation with baseline HbA1c (r = 0.40, P , 0.002) than with follow-up HbA1c (r = 0.034, P , 0.007).