Early onset symptomatic neuropathy in a child with Type 1 Diabetes mellitus.

Diabetic neuropathy (DN) is a major complication of Type 1 Diabetes Mellitus (T1DM). It is usually subclinical in childhood, but can cause significant impairment with its progression through to adulthood. Current guidelines vary in their recommendation regarding screening for DN in children with T1DM, with some advocating starting screening 5 years after the diagnosis of T1DM. Clinical assessment comprising of history and neurological examination is the most commonly used method for screening, though Nerve Conduction Studies (NCS) provide better sensitivity in picking up early subclinical diabetic neuropathy. We describe an adolescent female with poorly controlled T1DM, presenting with symptomatic diabetic neuropathy within 2 years of disease onset and as the initial long term complication. Thus, guidelines regarding screening for DN may need revision, to start screening earlier than presently recommended, and NCS could play a prominent role in screening children with significant risk factors for developing DN.