Diabetes mellitus exacerbates the clinical and electrophysiological features of Guillain-Barré syndrome.

BACKGROUND AND PURPOSE: It is known that underlying diabetes mellitus (DM) can affect the clinical and electrophysiological pattern of coexisting peripheral neuropathies of other etiologies. The aim of this study was to identify the effect of underlying DM on the clinical and electrophysiological features of Guillain-Barré syndrome (GBS) and on the prognosis of GBS with regard to functional outcome.

METHODS

This study prospectively included 27 GBS patients with DM (GBS-DM+) and 58 GBS patients without DM (GBS-DM-) from two university-based hospitals. The clinical and electrophysiological findings were compared between the two groups. The functional outcomes were quantified by measuring the Hughes grade, whose values were compared between the groups at 3 months after symptom onset.

RESULTS

All three sudden deaths that occurred during the acute stage of GBS were GBS-DM+ patients. GBS-DM+ patients had a tendency toward more frequent sensory involvement, and specific electrophysiological patterns and calculated indices disclosed a distal accentuation of conduction abnormalities in these patients. In addition, multivariate analysis identified history of mechanical ventilation (odds ratio 10.057, 95% confidence interval 2.057-49.164, P = 0.04) and DM (odds ratio 9.049, 95% confidence interval 2.152-38.044, P = 0.003) as independent factors for poor functional outcome at 3 months.

CONCLUSIONS

The findings of this study suggest that DM exacerbates the clinical and electrophysiological features of GBS and influences long-term disability. Both chronic inflammation and nerve ischaemia in DM may intervene in the disease course of GBS, which is a prototype of acute inflammatory neuropathy.