Authors
  Kennedy WR.  Navarro X.  Sutherland DE.
Title
  Neuropathy profile of diabetic patients in a pancreas transplantation
  program.
Source
  Neurology.  45(4):773-80, 1995 Apr.
Abstract
  We describe the results of extensive neurologic evaluation of 290 patients
  with insulin-dependent diabetes mellitus who came to our institution as
  potential recipients of a pancreas transplant. Large nerve fibers were
  evaluated by motor and sensory nerve conduction, small sensory fibers by
  thermal sensation thresholds, vagal and vasomotor functions by
  cardiovascular reflexes, and sympathetic sudomotor fibers by silicone
  imprints and evaporimetry. A scored anamnesis revealed symptoms of
  neuropathy in 86% of patients; 94% had an abnormal neurologic examination.
  The most frequently abnormal measurements of motor conduction were the
  amplitude of the extensor digitorum brevis muscle action potential to
  peroneal nerve stimulation and the conduction velocity of peroneal and
  tibial nerves in more than 80% of patients. Sensory nerve action
  potentials were abnormal in 76% and the distal latency of the sural nerve
  in 91%. Heart rate variability with deep breathing and during a Valsalva's
  maneuver was abnormal in 90% and 88%. Sudomotor function was reduced in
  59% on the foot. Thermal sensitivity limen was above normal limits in 95%
  in the foot and 77% in the hand. Composite indexes of the degree of
  abnormality found for each type of function tested were correlated one
  with another, but were not predictive of results for any other test. The
  neuropathy of most patients was symmetric, involving to a similar degree
  motor, sensory, and autonomic nerves. Thus, diabetic neuropathy is very
  common and severe among patients who decide to be candidates for pancreas
  transplantation.