Which complications of pediatric type 1 diabetes mellitus (DM) are related to peripheral and autonomic neuropathy?

Updated: Jul 03, 2019
  • Author: William H Lamb, MD, MBBS, FRCP(Edin), FRCP, FRCPCH; Chief Editor: Sasigarn A Bowden, MD  more...
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Answer

The peripheral and autonomic nerves are affected in type 1 diabetes mellitus. [17] Hyperglycemic effects on axons and microvascular changes in endoneural capillaries are amongst the proposed mechanisms. (In adults, peripheral neuropathy usually occurs as a distal sensory loss.)

Autonomic changes involving cardiovascular control (eg, heart rate, postural responses) have been described in as many as 40% of children with diabetes. Cardiovascular control changes become more likely with increasing duration and worsening control. [18] In a study by 253 patients with type 1 diabetes (mean age at baseline 14.4 y), Cho et al reported that the prevalence of cardiac autonomic dysfunction increases in association with higher body mass index and central adiposity. [19]

Gastroparesis is another complication, and it which may be caused by autonomic dysfunction. Gastric emptying is significantly delayed, leading to problems of bloating and unpredictable excursions of blood glucose levels.


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