Peripheric and automatic neuropathy in children with type 1 diabetes mellitus: the effect of L-carnitine treatment on the peripheral and autonomic nervous system.
To determine neuropathy frequency with electromyography (EMG) in asymptomatic diabetic children, and to demonstrate whether the electromyographical abnormalities noted improve after L-carnitine treatment. This study was carried out on 51 type 1 diabetes mellitus patients (of whom, 26 were female; average age 12) and 21 healthy children as the control group. Thirty four patients, whose nerve conduction velocity (NCS) was diagnosed as pathological, were treated with L-carnitine (dosage: 2 g/m2/day) for two months and their NCS checked at the end of the treatment period. At least one electrophysiological parameter was abnormal in 38 out of 51 patients (74.6%). At the end of the treatment, Stage 1 a patients (NCS pathologic and neurologic examination normal) demonstrated a 44% improvement in all pathologic NCS parameters and a 50% improvement in sympathetic skin responses (SSR), while in Stage 1 b patients (NCS and neurologic examination pathologic) a matching ratio of improvement was detected in SSR but no definite improvement was noted in the all pathologic NCS parameters. Starting carnitine treatment in the early stages may be more effective in the treatment of sub-clinical neuropathy. A two-month treatment period may not be sufficient in detecting an electrophysiological improvement in cases where neurological deficits had been determined