Autonomic neuropathy and survival in diabetes mellitus: effects of pancreas transplantation.
Cardiorespiratory reflexes were studied during slow breathing and a Valsalva maneuver in 232 Type 1 (insulin-dependent) diabetic subjects. At 1 to 7 years follow-up, death occurred in 23.4% of 175 patients with abnormal reflexes and in 3.5% of 57 patients with normal reflexes. The mortality rates of diabetic subjects with abnormal reflexes were 17% at 2.5 years, 33% at 5 years and 40% at 7 years, significantly higher than for patients with normal reflexes (4.6%, 4.6% and 13.8%). Among patients with abnormal reflexes, patients with a functioning pancreas transplantation had better survival rates than patients with a failed transplantation, and in long-term follow-up better than patients without transplantation. A functioning transplantation prevented the progressive decline of cardiorespiratory reflex function that occurred over time in control patients.
Department of Neurology, University of Minnesota, Minneapolis.
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Navarro
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Kennedy
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Sutherland
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery*; D003929:Diabetic Neuropathies / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D008297:Male; D016035:Pancreas Transplantation / Q000502:physiology*; D014636:Valsalva Maneuver