Department of Neurology, Biological Science Division, University of Chicago, Chicago, Illinois, USA.
Department of Public Health Sciences, Biological Science Division, University of Chicago, Chicago, Illinois, USA.
Muscle Nerve. 2023 Sep;68(3):329-333. doi: 10.1002/mus.27930. Epub 2023 Jul 13.
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.
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.
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).
If successful, ITx has a good long-term safety profile for peripheral nerve toxicity, and a favorable effect on diabetic neuropathy.
简介/目的：胰岛移植（ITx）越来越多地应用于脆性 1 型糖尿病（T1D）患者。如果成功，ITx 可导致无胰岛素的血糖正常，但由于需要终身免疫抑制，其应用受到限制。本研究的目的是评估 ITx 对脆性 T1D 患者多发性神经病的发生和病程的长期影响。
在这项前瞻性、单中心研究中，13 名脆性 T1D 患者（4 名男性和 9 名女性）在 ITx 前进行了基线神经检查，计算了犹他州神经量表（UNS）和有限的神经传导研究，并在实现胰岛素独立性的患者中每年进行一次检查。
患者的随访时间为 17 至 133 个月。除了腓肠神经（50.34±6.12 对 52.42±6.47 ms，P=0.005）和尺神经（27.5±2.15 对 29.45±2.10 ms，P=0.009）的 F 波潜伏期显著下降和尺神经感觉神经传导速度（49.98±6.27 对 47.19±5.36 m/s，P=0.04）显著增加外，UNS 和神经传导研究参数在基线和随访结束时没有显著差异。
如果成功，ITx 对周围神经毒性具有良好的长期安全性，并对糖尿病性神经病有有利影响。
