Ultrasonography as a potential clinical tool for anesthesiologists in assessing diabetic peripheral neuropathy: a correlational study of lower extremity nerve morphology and electrophysiological function

Objective This study evaluated the cross-sectional areas (CSAs) of lower-extremity peripheral nerves in patients with type 2 diabetes mellitus (T2DM) to assist in assessing diabetic peripheral neuropathy (DPN). Methods 141 participants were categorized into three groups: 41 non-diabetic controls (NDM), 56 T2DM patients without DPN (DM), and 44 T2DM patients with DPN (DPN). Cross-sectional areas of multiple lower-extremity nerves, nerve conduction studies, and vibration perception threshold (VPT) were measured to investigate the diagnostic value of high-resolution ultrasonography (HRU) for DPN. Results The sciatic, tibial, and posterior tibial nerve (PTN) CSAs were significantly larger in the DPN group compared to both the NDM and DM groups (p < 0.05), while the peroneal nerve showed no significant difference. No significant CSA differences existed between the NDM and DM groups for the sciatic and tibial nerves; however, the PTN CSAs were larger in the DM group (p < 0.05). The area under the curve (AUC) values for HRU in detecting DPN ranged from 0.615 to 0.646, comparable to the VPT-derived AUC of 0.674 (p > 0.05 for all comparisons). Nerve CSAs showed negative correlations with HbA1c and fasting blood glucose levels, but no significant correlation with diabetes duration. Conclusions Ultrasonography may be a valuable diagnostic tool for DPN. HRU could potentially replace VPT testing for anesthesiologists to evaluate peripheral neuropathy.