This systematic review evaluates the efficacy of sural nerve ultrasonography in diagnosing diabetes mellitus (DM) and its common complication, diabetic polyneuropathy (DPN). DPN frequently affects the sural nerve, making it a relevant focus for assessment in diabetic patients. A comprehensive meta-analysis was conducted, encompassing 32 ultrasonographic studies published between 2015 and 2023, which measured the cross-sectional areas (CSAs) of sural nerves in both healthy individuals and those with diabetes. The analysis included sub-groups based on geographical location and measurement sites.
The findings revealed that the mean CSA of the sural nerve was significantly larger in diabetic patients with DPN compared to healthy individuals, indicating that ultrasonographic assessment can effectively differentiate between these two populations across various regions. Furthermore, an age-dependent increase in CSA was observed in healthy subjects, highlighting a notable difference when comparing pediatric populations to adults.
These results underscore the potential of sural nerve ultrasonography as a valuable diagnostic tool for identifying diabetic adults with DPN based on CSA measurements. The ability to distinguish between healthy and diabetic individuals using this method offers a non-invasive approach to early diagnosis and intervention. However, the review also emphasizes the need for future research to explore how other factors, such as body metrics and age, influence sural nerve CSA measurements. Additionally, establishing specific cut-off values for DPN diagnosis may be necessary to account for variations in different geographical regions, ensuring more accurate and tailored assessments in diverse patient populations.
