Medial plantar sensory response. Sensitive indicator of peripheral nerve dysfunction in patients with diabetes mellitus

The effects of near-normal glucose control on nerve conduction results were studied in 10 patients with insulin-dependent diabetes mellitus who underwent a six-month program of intensification of therapy. The most striking electrophysiologic abnormality was the medial plantar sensory nerve conduction response. A sensory nerve action potential could not be elicited in seven of the 10 patients at the baseline evaluation. Over the six-month period of near-normal glucose control, there was a return of sensory nerve action potential in all 10 patients. Medial plantar sensory nerve conduction responses appear to be a sensitive and early electrophysiologic indicator of peripheral nerve dysfunction in patients with diabetes mellitus. Near-normalization of plasma glucose levels by intensification of diabetes management may be accompanied by correction of this early abnormality.