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Effect of pancreatic and/or renal transplantation on diabetic autonomic neuropathy

By J. Nusser, R. Scheuer, D. Abendroth, Wolf-Dieter Illner, R. Landgraf and Walter Land

Abstract

Thirty-nine Type 1 (insulin-dependent) diabetic patients were studied prospectively after simultaneous pancreas and kidney (n=26) and kidney grafting alone (n=13) by measuring heart rate variation during various manoeuvers and answering a standardized questionnaire every 6 to 12 months post-transplant. While age, duration of diabetes, and serum creatinine (168.1±35.4 vs 132.7±17.7 mgrmol/l) were comparable, haemoglobin A1 levels were significantly lower (6.6±0.2 vs 8.5±0.3%; p<0.01) and the mean observation time longer (35±2 vs 25±3 months; p<0.05) in the pancreas recipients when compared with kidney transplanted patients. Heart rate variation during deep breathing, lying/standing and Valsalva manoeuver were very similar in both groups initially and did not improve during follow-up. However, there was a significant reduction in heart rate in the pancreas recipient group. Autonomic symptoms of the gastrointestinal and thermoregulatory system improved more in the pancreas grafted subjects, while hypoglycaemia unawareness deteriorated in the kidney recipients. This study suggests that long-term normoglycaemia by successful pancreatic grafting is able to halt the progression of autonomic dysfunction.

Topics: Medizin, ddc:610
Year: 1991
DOI identifier: 10.1007/bf00587635
OAI identifier: oai:epub.ub.uni-muenchen.de:7891
Provided by: Open Access LMU

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Citations

  1. (1987). Defective glucose counterregulation after strict glycemic control of insulin-dependent diabetes mellitus.

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