Follow-up study of sensory-motor polyneuropathy in type 1 (insulin-dependent) diabetic subjects after simultaneous pancreas and kidney transplantation and after graft rejection.
The influence of successful simultaneous pancreas and kidney transplantation on peripheral polyneuropathy was investigated in 53 patients for a mean observation period of 40.3 months. Seventeen patients were followed-up for more than 3 years. Symptoms and signs were assessed every 6 months using a standard questionnaire, neurological examination and measurement of sensory and motor nerve conduction velocities. While symptoms of polyneuropathy improved (pain, paraesthesia, cramps, restless-legs) and nerve conduction velocity increased, there was no change of clinical signs (sensation, muscle-force, tendon-reflexes). Following kidney-graft-rejection there was a slight decrease of nerve conduction velocity during the first year, which was not statistically significant. Following pancreas-graft rejection there was no change of nerve conduction velocity during the first year. Comparing the maximum nerve conduction velocity of the patients with pancreas-graft-rejection to the nerve conduction velocities of these patients at the end of the study, there was a statistically significant decrease of 6.5 m/s. In conclusion, we believe that strict normalization of glucose metabolism alters the progressive course of diabetic polyneuropathy. It may be stabilized or partly reversed after successful grafting even in long-term diabetic patients.
Department of Internal Medicine Innenstadt, University of Munich, FRG.
W
W
Müller-Felber
R
R
Landgraf
S
S
Wagner
N
N
Mair
J
J
Nusser
M M
MM
Landgraf-Leurs
A
A
Abendroth
W D
WD
Illner
W
W
Land
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology* / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000601:surgery; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D009431:Neural Conduction; D009475:Neurons, Afferent / Q000502:physiology*; D016035:Pancreas Transplantation / Q000276:immunology / Q000502:physiology*; D010543:Peroneal Nerve / Q000503:physiopathology