Autonomic neuropathy and survival in diabetes mellitus: effects of pancreas transplantation

Diabetologia. 1991 Aug;34 Suppl 1:S108-12. doi: 10.1007/BF00587633.

Abstract

Cardiorespiratory reflexes were studied during slow breathing and a Valsalva maneuver in 232 Type 1 (insulin-dependent) diabetic subjects. At 1 to 7 years follow-up, death occurred in 23.4% of 175 patients with abnormal reflexes and in 3.5% of 57 patients with normal reflexes. The mortality rates of diabetic subjects with abnormal reflexes were 17% at 2.5 years, 33% at 5 years and 40% at 7 years, significantly higher than for patients with normal reflexes (4.6%, 4.6% and 13.8%). Among patients with abnormal reflexes, patients with a functioning pancreas transplantation had better survival rates than patients with a failed transplantation, and in long-term follow-up better than patients without transplantation. A functioning transplantation prevented the progressive decline of cardiorespiratory reflex function that occurred over time in control patients.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1 / mortality
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Diabetes Mellitus, Type 1 / surgery*
  • Diabetic Neuropathies / mortality
  • Diabetic Neuropathies / physiopathology*
  • Female
  • Follow-Up Studies
  • Heart Rate
  • Humans
  • Male
  • Pancreas Transplantation / physiology*
  • Valsalva Maneuver