Evaluation of median, sural and posterior tibial nerve crosssectional area by ultrasonography in prediabetes and diabetes patients.

The aim of this study is to compare ultrasonographic measurements of median, sural, and tibialis posterior nerve cross-sectional areas in prediabetic patients before the onset of overt neuropathy with diabetes and control groups. This study, designed as a case-control cross-sectional clinical study, included 30 patients in the prediabetes group, 30 patients in the diabetes group, and 30 healthy individuals in the control group. The demographic data of the participants, duration of illness, body mass index (BMI), fasting plasma glucose (FPG), and HbA1c level were recorded and assessed using the Self-Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale. Median, sural, and posterior tibial nerve cross-sectional areas (CSA) were measured using ultrasound in the non-dominant extremities of all participants. In the prediabetes and diabetes groups, median (control-prediabetes: p<0,001, control-diabetes: p<0,001), sural (control-prediabetes: p<0,001, control-diabetes: p<0,001), and posterior tibial CSAs (control-prediabetes: p<0,001, control-diabetes: p=0,002) were found to be statistically significantly larger compared to the control group. Between the prediabetes and diabetes groups, there was no significant difference in median and posterior tibial CSA, however, the sural CSA was statistically significantly larger in the diabetes group compared to the prediabetes group (p=0,009). Furthermore, a positive correlation was found between disease duration and sural CSA in the diabetes group. In conclusion, morphological changes in nerves can be detected by ultrasound during the prediabetes stage before overt neuropathy begins. Ultrasound is an effective and easily accessible tool for detecting changes in nerve morphology in diabetic and prediabetic patients.