Diabetic Neuropathy Study
Diabetic neuropathies are a consequence of long term hyperglycemia and occur whether the diabetes is insulin dependent or not. In patients with juvenile diabetes, these problems arise in the third through fifth decade and, in type two diabetes, usually after the fifth decade of life. Focal mononeuropathies can cause third and sixth cranial nerve palsies, painful intercostal neuropathy, and isolated muscle weakness involving the hip girdle. These mononeuropathies are likely vascular in origin and usually resolve over a period of months. While the distal symmetrical neuropathies may have an element of ischemia, they most likely represent a confluence of metabolic disturbances.
There are multiple characteristics used to classify diabetic neuropathy including whether they are symmetric or asymmetric, sensory or autonomic, mononeuropathy or polyneuropathy, and entrapment neuropathy or not. Many patients have mixed varieties of neuropathy involving the sensory nerves of the distal limbs and the autonomic nervous system. Autonomic neuropathies can result in disturbances of gastrointestinal, sexual, and vasomotor functions. Many of the sensory neuropathies involve pain which is frequently described as burning and numbness. These symptoms interfere with sleep, daily activities, and quality of life.
While the treatment of diabetic neuropathy has improved with the use of antiepileptic drugs and antidepressants, it still remains frustrating. Most of the commonly used medications have anticholinergic side effects or cause sedation. At best, they are only partially effective because they do not treat the underlying cause of the neuropathy but only the symptoms. The goal of this study was to determine if we could improve patients reports of pain and numbness with the utilization of nutritional supplements that may partially address the causes of diabetic complications.
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