Evaluation of sympathetic skin response for early diagnosis and follow-up in childhood type 1 diabetes mellitus with peripheral neuropathy

Abstract Background: The morbidity of type 1 diabetes mellitus (T1DM) in children is increasing and peripheral neuropathy is one of the common clinical complications. The aim of this study was to evaluate the value of sympathetic skin response (SSR) and NCS for early diagnosis and follow-up of peripheral neuropathy in children with T1DM .Methods: Enrolling 85 children patients and 30 healthy controls, aged 14 years and younger, with clinically diagnosed T1DM from endocrinology wards between October 2017 to March 2020. Compared the characteristics of SSR and nerve conduction study (NCS) in T1DM patients, and analyzed the abnormality of SSR and NCS in different duration as well as the changes of SSR and NCS after therapy for 6 months.Results: The SSR latencies of T1DM group were prolonged and the conduction velocity were slower than the control group (P<0.05).There were no statistical differences between the abnormal rates of SSR and NCS, the abnormal rates of SSR combined with NCS were 76.5% (65/85) and were higher than those of single SSR or NCV test (P＜0.001).The abnormal rates of SSR and NCV in long duration of disease were higher than those in short duration of disease (P＜0.05). Among 65 children with diabetic neuropathy, the onset latencies of SSR were shortened and the NCS were improved after treatment (P<0.05).Conclusions: The combination of SSR and NCS were superior to the single SSR or NCS, therefore, SSR and NCS could provide the accurate early diagnosis and follow-up of pediatric diabetic neuropathy.