Whether nerve fiber loss, a prominent feature of advanced diabetic neuropathy, can be reversed by reestablishment of normal glucose control remains questionable. We present 8-year follow-up data on epidermal nerve fiber (ENF) density and neurological function in patients with type 1 diabetes after simultaneous pancreas and kidney transplantation (SPK) with long-term normoglycemia. Distal thigh skin biopsies with ENF counts, vibration perception thresholds (VPTs), autonomic function testing (AFT) and electrophysiological examinations were performed at time of SPK and 2.5 and 8 years after SPK in 12 patients with type 1 diabetes. In comparison to controls, baseline ENF density, VPT and AFT results of patients indicated severe neuropathy. At follow-up, all SPK recipients were insulin independent with excellent glycemic control and kidney graft function; however, the severe ENF depletion present at baseline had not improved, with total ENF absence in 11 patients at 8-year follow-up. Similarly, no amelioration occurred in the VPT and AFT results. Numerical improvement was seen in some electrophysiological parameters; however, statistical significance was achieved only in median motor nerve conduction velocity. ENF loss and functional deficits in advanced diabetic peripheral neuropathy are rarely reversible, even by long-term normoglycemia, which underscores the importance of neuropathy prevention by early optimal glycemic control.

• MeSH
• diabetes mellitus 1. typu chirurgie   MeSH
• diabetické nefropatie etiologie   patologie   MeSH
• hodnoty glomerulární filtrace MeSH
• kůže inervace   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• následné studie MeSH
• nervová vlákna patologie   MeSH
• pooperační komplikace MeSH
• přežívání štěpu MeSH
• prognóza MeSH
• rejekce štěpu etiologie   patologie   MeSH
• rizikové faktory MeSH
• transplantace ledvin škodlivé účinky   MeSH
• transplantace slinivky břišní škodlivé účinky   MeSH
• vyšetření funkce ledvin MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH