Objective: Diabetic foot is one of the basic causes of lower extremity amputation. The aim of this study is to determine which examination method of nerve conduction disorders may be used predominantly for early diagnosis of diabetic foot development in the follow-up of diabetic patients.
Material and Method: The study consists of 3 different groups (n=150) of patients diagnosed with type 2 diabetes (DM). Group 1; 50 patients with diabetic foot complications (DFC+), Group 2; 50 patients without diabetic foot complications and with polyneuropathy (DFC-/PNP+), Group 3; 50 patients without diabetic foot complications and without polyneuropathy (DFC-/PNP-). Diabetic foot wounds were grouped by PEDIS classification. A total of 150 DM patients were included. The age, sex, diabetes duration, blood glucose levels, HbA1c measurements, and standard electroneuromyography (ENMG) findings were compared.
Findings: Age, sex, diabetes duration, blood glucose, HbA1c values and electroneuromyography (ENMG) for nerve amplitude,velocity and latency results were compared among the groups. A significant statistical difference was found between three groups when age, sex, HgbA1c, fasting blood glucose, diabetes duration was evaluated (p<0.05). All DFC+ patients had PNP+. In the DFC+ group, unlike DFC-/PNP+ group, the motor nerves of the lower extremities were also involved. Tibial nerve velocity was lower than normal in DFC+ patients and normal in other groups (p<0.05). A statistically significant difference was found in peroneal nerve conduction velocity between the DFC+ group and the DFC- groups (p<0.05). Peroneal nerve conduction velocity was not statistically significant between DFC-/PNP+ and DFC-/PNP- groups (p>0.05). Peroneal nerve conduction velocity was lowest in the DFC+ group. This factor was considered as a risk factor for DFC development.
Conclusions: The slowdown in peroneal nerve conduction velocity and the increase in diabetes duration were the primary risk factors for diabetic foot development, and the decrease in tibial nerve velocity was also considered as significant. This study showed that the involvement of motor nerve conduction in the lower extremity was considered as a signal for diabetic foot development.