LONG-TERM EFFECTS OF PANCREATIC TRANSPLANTATION ON DIABETIC NEUROPATHY

Restoration of a long-lasting euglycemic state by a functioning pancre atic transplantation (PTx) is the most logical treatment for insulin-d ependent diabetes mellitus and for amelioration of secondary complicat ions, including neuropathy. We evaluated neurological function by clin ical examination, nerve conduction studies, and autonomic function tes ts in 115 patients with a functioning PTx and in 92 control patients t reated with insulin, at baseline and 1, 2, 3.5, 5, 7, and 10 years lat er. In control patients, neuropathy progressively worsened during foll ow-up. The clinical examination score and composite indices of abnorma lity of motor and sensory nerve conduction decreased significantly at all intervals tested. Autonomic function indices also decreased, but s ignificantly only after 1 year. In patients who received a successful PTx the neuropathy improved. The motor and sensory nerve conduction in dices increased significantly at all intervals after transplantation, whereas the clinical examination and autonomic tests improved only sli ghtly. Patients who received either a PTx alone, a PTx after a kidney graft, or simultaneous pancreatic and kidney transplantations improved similarly over the follow-up. These results indicate that a functioni ng PTx halts the progression and improves the signs of diabetic polyne uropathy by restoration of a normoglycemic state.