ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuromuscular Disorders and Peripheral Neuropathies
Clinical and Electrophysiological Characteristics of Myasthenia Gravis Patients with Concomitant Type 2 Diabetes Mellitus
Provisionally accepted
- 1Department of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
- 2Department of Neurology, the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
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Background and Objectives: Type 2 Diabetes Mellitus (T2DM) is a common comorbidity in late-onset myasthenia gravis (MG), with pre-existing T2DM in some MG patients hinting at a possible pathogenic connection between the two disorders. This study aims to explore the clinical and neurophysiological features of MG, with a particular focus on the electrophysiological disparities between MG patients with and without T2DM. Methods: In this retrospective study, 170 MG inpatients were recruited and divided into T2DM (n=51) and non-T2DM groups. Clinical profiles and electrophysiological characteristics were compared. Results: There were no significant differences between the two groups in terms of MG clinical classification, Quantitative MG (QMG) scores, or antibody profiles. Electrophysiologically, the T2DM group exhibited peripheral neuropathy, characterized by prolonged distal motor latencies, decreased compound muscle action potential (CMAP) amplitudes, slowed motor nerve conduction velocities, extended F-wave latencies, and sensory nerve dysfunction. In low-frequency repetitive nerve stimulation (LFRNS) of the facial nerve, the decrement pattern was predominantly “L-shaped” (minimal recovery) in T2DM patients, in contrast to the “U-shaped” pattern in non-T2DM patients. Accessory nerve LFRNS decrement showed a positive correlation with QMG score, fasting blood glucose levels, and diabetes duration. Conclusion: Patients with MG and concomitant T2DM demonstrate electrophysiological evidence of peripheral nerve impairment and a unique “L-shaped” decrement pattern on LFRNS of the facial nerve. This distinct electrophysiological phenotype likely reflects a complex interplay of metabolic derangements at the neuromuscular junction (NMJ). These results highlight the critical role of glycemic control in the management of MG.
Keywords: Electrophysiology, MyastheniaGravis, NeuromuscularJunction, Repetitive nerve stimulation, Typediabetesmellitus
Received: 27 Dec 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 Li, Liu, Yang, Zhang, Gong, Duan and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ying Liu
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