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Vascular complications
Diabetic nerve disease
Neuropathy
- Clinical neuropathy is rare in children and adolescents with satisfactory glycemic control
- Sensitive tests can detect subclinical neurological abnormalities, the natural history of these being unclear
- In the presence of poor diabetic control young people should be questioned and examined in relation to
- symptoms of numbness, pain, cramps and paresthesia
- skin sensation, vibration sense and light touch
- ankle reflexes
In specialist centers, abnormalities in the autonomic nervous system have been reported which include postural change in blood pressure, heart rate responses to Valsalva maneuver, sophisticated tests of cardiovascular reflexes, plus pupillary reflex changes. The significance of such findings is uncertain but would make close monitoring and improvements in glycemic control mandatory
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