“A Study Of High-Resolution Ultrasound Of Pheripheral Nerves (Ulnar, Median, Common Peroneal And Tibial) In Diabetic Neuropathy And Its Correlation With Nerve Conduction Study”

Background: Diabetic neuropathy is a prevalent complication of both type 1 and type 2 diabetes mellitus (DM). Diabetic peripheral neuropathy (DPN) affects approximately 30% of those with diabetes, primarily impacting the feet and legs, though it can also involve the arms and hands. Neuropathic pain in DPN can affect up to 30% of patients, significantly impairing quality of life, increasing dependence on medication, and correlating with higher morbidity and mortality rates. Aims and Objective: To assess the cross-sectional area (CSA) of specific peripheral nerves—namely, the median nerve at the wrist, ulnar nerve at the elbow, tibial nerve at the ankle, and common peroneal nerve at the knee— in individuals suspected of having DPN. Additionally, it sought to investigate the correlation between CSA measurements and nerve conduction studies (NCS), as well as to explore patterns of nerve involvement and morphological changes in these peripheral nerves. Material and Methods:This cross-sectional observational study was conducted at C.S.S. Hospital, affiliated with S.V.S.U., from February 2023 to August 2024, with approval from the Institutional Ethics Committee. Data were gathered from 70 patients exhibiting symptoms of neuropathy, including both outpatient and inpatient cases. High-resolution ultrasound and Nerve conduction study (NCV) of peripheral nerves was performed on patients diagnosed with Type 2 Diabetes Mellitus (T2DM), based on clinical symptoms and HbA1c levels. Conclusion: Our study demonstrated a positive correlation between increased cross-sectional areas (CSA) of peripheral nerves and abnormalities in nerve conduction studies (NCS). Ultrasound (US) effectively detected morphological changes in nerves before electrodiagnostic issues, indicating its potential for early DPN detection. DPN patients had significantly higher CSA values than those without the condition.We observed distinct NCS patterns: lower limb nerves typically showed axonopathy, while upper limb nerves exhibited more demyelination, underscoring the greater impact on lower limbs in DPN