To Identify Whether Ion Conductance Dysfunction Is an Early Electrophsiological Biomarker of Polyneuropathy in Diabetic Patients: a Longitudinal Study of Nerve Excitability in Diabetic Patients

Diabetic polyneuropathy is an important and major complication for diabetic patients. It will affect their life quality and increase the morbidity. Unfortunately, there is no effective prevention or therapeutic management till now. It might be due to lack of sensitive tool for early detection. Nerve excitability test is a new method to inform complementary information to conventional nerve conduction study (NCS) and has been applied on detecting neuropathy clinically for more than 10 years. In the previous studies for diabetic polyneuropathy, changes in nerve excitability indices in those patients with normal NCS were reported. Those results hint the sodium conductance dysfunction before the nerve conduction failure in patients. In this project, we plan to recruit 100-150 diabetic patients with/without clinical symptoms (fingers/toes numbness or mild weakness), the nerve conduction study (NCS) and quantitative sensory test (QST) will be checked. We enroll only those patients with normal NCS and QST to follow up for three years. During the following 36 months, clinical manifestation, clinical profiles (HbA1c. creatinin), NCS and nerve excitability test will perform. We will analysis the excitability indices to find (1) the pathphysiological mechanism of axon undergo in the early diabetic patients (2) which is most sensitive biomarker for patients is feasible to develop polyneuropathy (3) the natural trends of the ion conductance changes . Based on these three aims, we hope we could find a way to treat diabetic polyneuropathy in the future.