Chronic inflammatory demyelinating polyradiculopathy appears to be more common in patients with diabetes mellitus (DM) than in the general population. Diabetes may, therefore, predispose patients to the development or exacerbation of disimmunogenic peripheral neuropathies. This study explored the influence of underlying DM on the clinical and electrophysiologic features of Guillain-Barré syndrome (GBS).
METHODSConsecutive hospital admissions of patients with GBS were enrolled in this study. If available, subtypes were classified as acute demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN) or acute motor sensory axonal neuropathy (AMSAN) by using the results of anti-ganglioside antibody assays and serial nerve conduction study (NCS) findings. Diabetes mellitus was diagnosed using the criteria of the American Diabetes Association. Nerve conduction studies were performed with prolonged terminal latency and conduction block, used to identify AIDP. Functional outcomes of patients with GBS were determined at three months.
RESULTSSubjects were 27 patients with GBS and DM (GBS＋DM) and 58 patients with GBS without DM (GBS- DM). Ataxia as an initial symptom of GBS was more frequent in the GBS＋DM group than in the GBS-DM group (P＝0.02). At three months after symptom onset, only about half of the GBS＋DM patients could walk unaided, compared to 86% of the GBS-DM patients (P＝0.005). A multivariate analysis found that a history of mechanical ventilation (P＝0.04) and underlying DM (P＝0.003) were independent risk factors for poor functional outcome at three months after symptom onset.
CONCLUSIONThis study of patients hospitalized with Guillain- Barre′ syndrome found that diabetes mellitus exacerbates both the clinical and the electrophysiologic features of this disorder and influences its related long-term disability.