第二型糖尿病伴隨周邊神經病變之回溯性研究

研究目的：周邊神經病變是第二型糖尿病（type 2 diabetes mellius, T2DM）的常見併發症，會導致周邊神經傳導異常。本研究旨在探討糖尿病周邊神經病變的臨床表徵並且透過神經電生理學檢查，了解糖尿病周邊神經病變病患神經損傷情形。研究方法及資料：這是一篇回溯性研究（retrospective study），研究對象為經神經電學檢查後證實為糖尿病合併有周邊神經病變的第二型糖尿病患者。從2013年至2023年對於在彰化縣地區醫院確診糖尿病周邊神經病變患者進行了回溯性研究，數據收集包括正中神經、尺神經、脛神經、腓骨神經，腓腸神經測量神經傳導參數、周邊運動電位時間、反應振幅和運動傳導速度，以及神經的感覺傳導、糖尿病病程、高血壓、血脂異常、和生化參數的數據。 研究結果：我們總共收錄了16名第二型糖尿病合併有周邊神經病變的病患，在我們收集的第2型糖尿病合併有周邊神經病變患者中發現第二型糖尿病患者中周邊神經病變的比率高，傳導速率，運動反應振幅和神經感覺都有下降。糖控不佳的患者也有較高的周邊神經病變發生率。臨床上周邊神經病變的發生率與糖尿病病程長短之間在統計學上有顯著相關（p < 0.05）。血脂異常的組別之間在周邊神經病變的發生率上也有顯著差異。 結論與建議：研究強調了第二型糖尿病患者中周邊神經病變的高發生率及其與糖尿病控制不良的神經傳導異常之間的關聯，凸顯了早期診斷和管理神經病變以防止嚴重併發症的重要性。此外，適度的降低血清膽固醇對於維持神經功能可能也是重要的。

Objective: Peripheral neuropathy is among the common complications of Type 2 Diabetes Mellitus（T2DM）, forming a pathogenetic correlate of the condition with progressive damages in peripheral nerves. The current study was aimed at investigating clinical manifestations of diabetic peripheral neuropathy and, in the process, determining the extent of nerve damage occurring in patients diagnosed with diabetic peripheral neuropathy through neuroelectrophysiological examinations.Methods and Materials: The study methods and data to be used would involve a retrospective review of our patients with established type 2 diabetes, confirmed through neuroelectrophysiological examinations showing diabetic peripheral neuropathy. The data of the patients are collected from the year 2013 till the year 2023 retrospectively, who have been diagnosed as having diabetic peripheral neuropathy in the hospital of the county, which included the following: nerve conduction parameters of median, ulnar, tibial, fibular, and sural nerves, peripheral motor latency, amplitude of response, and motor conduction velocity, and sensory nerve conduction of the course in diabetes, hypertension, and dyslipidemia along with biochemical parameters. Study report prepared and differences subjected to statistical analysis.Results: We enrolled a total of 16 patients with type 2 diabetes mellitus（T2DM）who also had peripheral neuropathy. Among these patients, we found a high prevalence of peripheral neuropathy, accompanied by reduced conduction velocity, decreased motor response amplitude, and diminished sensory function.. Patients with poor glycemic control exhibited a higher incidence of peripheral neuropathy.Clinically, the incidence of peripheral neuropathy showed a statistically significant correlation with the duration of diabetes（p < 0.05）. Significant differences in the incidence of peripheral neuropathy were observed among groups with abnormal blood lipid levels. Moderately lowering serum cholesterol is crucial for maintaining nerve function.Conclusion and Suggestion: The study highlights the high incidence of peripheral neuropathy among T2DM patients and the association between nerve conduction abnormalities and poor diabetes control, underscoring the importance of early diagnosis and management of neuropathy to prevent severe complications.Key words: Diabetic Peripheral Neuropathy; Type 2 Diabetes