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 verlocity 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.