Long-term effects of pancreatic islet transplantation on polyneuropathy in patients with brittle diabetes: A single-center experience

Muscle Nerve. 2023 Sep;68(3):329-333. doi: 10.1002/mus.27930. Epub 2023 Jul 13.

Abstract

Introduction/aims: Pancreatic islet transplantation (ITx) is increasingly used in patients with brittle type 1 diabetes (T1D). If successful, ITx results in insulin-free euglycemia, but its application is limited by a need for lifelong immunosuppression. The aim of this study was to assess the long-term effects of ITx on the occurrence and course of polyneuropathy in a cohort of patients with brittle T1D.

Methods: In this prospective, single-center study, 13 patients (4 males and 9 females) with brittle T1D had a baseline neurological exam with the calculation of Utah Neuropathy Scale (UNS) and a limited nerve conduction study before ITx, and about yearly after in the patients who achieved insulin independence.

Results: Patients were followed for a period of 17 to 133 months. There was no significant difference between UNS and nerve conduction study parameters at baseline and at the end of follow-up, except for significant decreases in peroneal (50.34 ± 6.12 vs. 52.42 ± 6.47 ms, P = 0.005) and ulnar (27.5 ± 2.15 vs. 29.45 ± 2.10 ms, P = 0.009) F-wave latencies and an increase in ulnar sensory nerve conduction velocity (49.98 ± 6.27 vs. 47.19 ± 5.36 m/s, P = 0.04).

Discussion: If successful, ITx has a good long-term safety profile for peripheral nerve toxicity, and a favorable effect on diabetic neuropathy.

Keywords: F wave; brittle diabetes; islet transplantation; neuropathy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / surgery
  • Diabetic Neuropathies*
  • Female
  • Humans
  • Insulin
  • Islets of Langerhans Transplantation* / methods
  • Male
  • Neural Conduction
  • Polyneuropathies*
  • Prospective Studies

Substances

  • Insulin