Ulnar entrapment neuropathy in patients with type 2 diabetes mellitus: An electrodiagnostic study

• Published in: Diabetes research and clinical practice Vol. 104; no. 1; pp. 73 - 78
• Main Authors: Rota, Eugenia, Zavaroni, Donatella, Parietti, Letizia, Iafelice, Ilaria, De Mitri, Paola, Terlizzi, Emilio, Morelli, Nicola, Immovilli, Paolo, Guidetti, Donata
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.04.2014
• Subjects: Carpal tunnel syndrome; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - physiopathology; Diabetic neuropathy; Diagnosis, Differential; Electrodiagnosis - methods; Endocrinology & Metabolism; Female; Follow-Up Studies; Humans; Male; Median entrapment neuropathy at the wrist; Middle Aged; Neural Conduction - physiology; Polyneuropathies - physiopathology; Polyneuropathy; Retrospective Studies; Ulnar entrapment neuropathy at the elbow; Ulnar entrapment neuropathy at the wrist; Ulnar Nerve - physiopathology; Ulnar Nerve Compression Syndromes - diagnosis; Ulnar Nerve Compression Syndromes - etiology; Ulnar Nerve Compression Syndromes - physiopathology; Carpal tunnel syndrome; Ulnar entrapment neuropathy at the elbow; Diabetes mellitus; Ulnar entrapment neuropathy at the wrist; Diabetic neuropathy; Polyneuropathy; Median entrapment neuropathy at the wrist
• ISSN: 0168-8227; 1872-8227; 1872-8227
• DOI: 10.1016/j.diabres.2014.01.024

This study aimed to assess the prevalence and electrophysiological features of ulnar entrapment neuropathy in patients with type 2 diabetes mellitus (DM). Nerve conduction studies (NCS) were performed in a sample of consecutive diabetic patients aged 25–75 years, referred by the Diabetology Unit. NCS of the median, ulnar, radial, peroneal and sural nerves were performed on the non-dominant side. Median entrapment neuropathy at the wrist (MNW) and ulnar neuropathy at the elbow (UNE) and wrist (UNW) were diagnosed according to standard electrodiagnostic criteria. Sixty-four patients were enrolled, 28 male (44%), average age 61, average DM duration 14.5 years. Polyneuropathy was diagnosed in 45 subjects (70%). UNE was detected in 22 patients (34%) (4 did not have polyneuropathy), in the abductor digiti minimi in 16, the first interosseus in 14 and in both in 8. UNW was detected in 7 (11%) subjects and MNW in 40 (63%). NCS alterations consistent with ulnar neuropathy were detected in a high proportion of patients (45%), suggesting that the ulnar nerve is very susceptible to focal entrapment in DM. Upper limb sensory and motor NCS, including motor conduction velocity across the elbow, should be considered in the staging of DM patients.