| Objective:To evaluate the nerve in patients with diabetes mellitus(DM) by motor unit number estimation, assess the motor neuron function of diabetic sensory nerve, analyze the relationship between MUNE and fasting blood glucose, duration of diabetes, blood hematoglobin A1c(HbA1c).Methods:sixty-nine patients consisted with WHO diagnostic criteria for dia betes, forty-five healthy people as controls, the motor unit number of thenar, hypothenar, and extensor digitorum brevis muscles were counted by Keypointfo ur electromyographic evoked potential machine; we also recorded fasting blood glucose, duration of diabetes and Hbalc of DM patients. We compared the n umber of motor unit between diabetic patients and controls. According to the n-erve conduction, DM patients were divided into normal group, sensory nerve abnormalities group, mixed group of neurological abnormalities. We compared the motor unit of four groups and analyzed the relationship between MUNE with fasting blood glucose, duration of diabetes and HbAlc.Results:In the diabetic group, the motor units of thenar, hypothenar, extensor digitorum brevis muscle are 111.3±67.2,111.8±73.4,68.3±57.0,Max area are 41.7±14.9 mVms,45.0±13.7 mVms,21.8±10.4 mVms, Mean area are 1.0±0.5 mVms,0.9±0.3 mVms,1.0±0.5 mVms, while, in the control group,the motor unit are 192.2±61.2,165.7±16.9,113.1±48.0, Max area are 52.1±12.4 mVms,51.8±11.9 mVms,36.8±10.0 mVms, Mean are are 0.7±0.2 mVms,0.7±0.2 mVms,0.8±0.3 mVms. Compare with the control group, the motor unit number in diabetic group are less, Max area are smaller, mean area are larger (p<0.05); the motor unit of hypothenar muscles in the sensory nerve abnormalities group, mixed group of neurological abnormalities, DM normal and control group are 113.4±59.7,60.6±20.3,182.9±69.3,165.7±76.9 respectively, the motor unit of extensor digitorum brevis muscle are 91.1±81.4,48.0±27.6,128.8±26.2,113.1±48.0 respectively, the ulnar nerve CMAP amplitude are 9.1±2.1mv,7.3±2.6 mv,9.8±1.7 mv,9.8±1.6 mv respectively, common peroneal nerve CMAP amplitude are 5.1±1.5 mv,2.4±1.1 mv,5.3±1.7 mv,5.8±2.1 mv respectively. Compared with the control group, the motor unit of hypothenar and extensor digitorum brevis muscle reduce in sensory nerve abnormalities group and mixed group of neurological abnormalities (p<0.05), but they are no significant differences in DM normal group, the ulnar nerve and common peroneal nerve CMAP amplitude reduce in mixed group of neurological abnormalities (p<0.05), but they are no significant differences in DM normal group and sensory nerve abnormalities group; Compare with DM normal group, the motor unit of hypothenar and extensor digitorum brevis muscle in sensory nerve abnormalities group and mixed group of neurological abnormalities reduce (p<0.05), the ulnar nerve and common peroneal nerve CMAP amplitude reduce in mixed group of neurological abnormalities (p<0.05), but they are no significant differences in sensory nerve abnormalities group; Compare with the sensory nerve abnormalities group, the motor unit of hypothenar and extensor digitorum brevis muscle and the CMAP amplitude of the ulnar nerve and common peroneal nerve reduce in mixed group of neurological abnormalities (p<0.05).The rage of diabetes duration is 1 month to 30 year, and the rage of the fasting plasma glucose is 5.0-20.4mmol/L, also the rage Hbalc is 3.3～16.8%, the motor unit of thenar, hypothenar and extensor digitorum brevis muscle in diabetes group is negatively correlated with duration of diabetes (p<0.05), and Hbalc (p<0.05), but have no evident correlation with fasting blood glucose(p>0.05).Conclusion:The functional motor unit loss in Diabetic patients, and MUNE can detect it earlier than CMAP; compensatory collateral regeneration exist in DM patients with peripheral nerve damage; There is clinical motor nerve damage in patients with diabetic sensory neuropathy, and the loss of motor unit is impacted by the duration of diabetes mellitus and HbAlc.
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