Chronic inflammatory demyelinating polyneuropathy in diabetes

Five patients with type II diabetes developed a chronic relapsing (2 pts.) and chronic progressive (3 pts.) polyneuropathy. Four patients had distal symmetric weakness, paresthesias and absent tendon jerks. In one patient weakness was asymmetric. All patients fulfilled at least 2 out of 4 electrodiagnostic criteria for chronic inflammatory demyelinating polyneuropathy (CIDP)(Neurology 1991;41:617). CSF protein was increased in 2 patients. Nerve biopsy showed deremyelination in all patients. Antibodies to SGPG, sulfatides, GM1, GDlb, GDla, GM2 and tubulin were negative. CIDP is aasociated to diabetes in 12% of our population. It is important for therapeutic implications to distinguish CIDP occurring in diabetes from diabetic neuropathy. Although a chance association is possible, diabetes might represent a triggering event in CIDP as inflammatory features are reported in sural nerve biopsies of diabetics.