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Diabetes Care Publish Ahead of Print published online ahead of print April 28, 2008
DOI: 10.2337/dc07-2409
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Original Research

Epidermal innervation in type 1 diabetic patients: a 2.5-year prospective study after simultaneous pancreas/kidney transplantation

Petr Boucek, MD1, Terezia Havrdova, MD1, Ludek Voska, MD2, Alena Lodererova, MS2, Lan He3, Frantisek Saudek, MD1, Kvetoslav Lipar, MD1, Milos Adamec, MD1 and Claudia Sommer, MD3

1Diabetes and Transplant Centers
2Department of Pathology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
3Department of Neurology, University of Würzburg, Würzburg, Germany

petr.boucek{at}ikem.cz

ABSTRACT

Objective: To assess the effect of normoglycemia following simultaneous pancreas/kidney transplantation (SPK) on neurological function and intraepidermal nerve fiber density (IENFD) in patients with type 1 (DM).

Methods: We performed vibration perception threshold (VPT) and autonomic function testing (AFT) and assessed IENFD in skin biopsies from the lower thigh and upper calf in 14 healthy controls and 18 patients with DM at the time of and at 21–40 (median 29) months post-SPK.

Results: At baseline, significantly increased VPTs, pathological AFT results and severe reduction in IENFD were present in SPK recipients. After SPK, an increase of IENFD in the thigh of more than 1 ENF/mm was noted in 3 patients (median 4.1; range 1.9-10.2), but changes were not significant for the group as a whole.

Conclusions: We conclude that irreversible nerve damage might be present in some SPK recipients, or that longer periods of normoglycemia might be needed to allow nerve regeneration.


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Copyright © 2008 by the American Diabetes Association.