Peripheral Neuropathy in Diabetics Notes

Taking some notes here on my research relating to peripheral neuropathy in type 1 diabetes – especially on prevention and treatment options

General

Alpha-lipoic acid treatment

Primrose oil
  • Painful diabetic neuropathy management
    • Other promising modalities from small randomised controlled trials include the use of alpha-lipoic acid as an antioxidant and evening primrose oil through increased PGE1 synthesis. Both treatments improve nerve function and result in symptomatic improvement.[13] The drawbacks for these treatments include chelation of metals such iron and copper with alpha-lipoic acid and inhibition of platelet aggregation with evening primrose oil. Close monitoring of patients on these treatments are advised.[13]
    • Ref 13 is Ametov AS, Barinov A, Dyck PJ et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: the SYDNEY trial. Diabetes Care 2003; 26: 770–776.
  • Treatment of diabetes mellitus-associated neuropathy with vitamin E and Eve primrose
Vitamin E
  • Tutuncu NB, Bayraktar N, Varli K. Reversal of defective nerve conduction with vitamin E supplementation in type 2 diabetes. Diabet Care. 1998;21:1915–8.  [PubMed]
    • This study shows that defective nerve conduction in diabetic subjects with mild-to-moderate peripheral neuropathy may be improved by pharmacological doses of vitamin E supplementation.   Further studies with a larger number of patients for longer periods of time are needed.
  • Treatment of diabetes mellitus-associated neuropathy with vitamin E and Eve primrose
    • The combination of vitamin E and Eve Primrose is beneficial in the management of mild to moderate diabetic neuropathy.
Exercise
  • 2014: Exercise Intervention Studies in Patients with Peripheral Neuropathy: A Systematic Review
    • Overall, balance training appears to be the most effective exercise intervention. Studies focusing exclusively on strength, or a combination of endurance and strength, appear to have a lower impact. For metabolically-induced neuropathies, endurance training also plays an important role. Further research with high methodological quality needs to be conducted in order to establish evidence-based clinical recommendations for neuropathic patients.
Acetyl-L-carniting

Some people with peripheral neuropathy try complementary and alternative treatments for relief of their symptoms. Although researchers haven’t studied these techniques as thoroughly as they have most medications, the following therapies have shown some promise: 

Acupuncture. Acupuncture, which involves inserting thin needles into various points on your body, may reduce peripheral neuropathy symptoms. You may need multiple sessions before you notice improvement. Acupuncture is generally considered safe when performed by a certified practitioner using sterile needles. 

Alpha-lipoic acid. Used as a treatment for peripheral neuropathy in Europe for years, this antioxidant may help reduce symptoms. Discuss using alpha-lipoic acid with your doctor because it may affect blood sugar levels. Other side effects may include stomach upset and skin rash. 

Herbs. Certain herbs, such as evening primrose oil, may help reduce neuropathy pain in people with diabetes. Some herbs interact with medications, so discuss herbs you’re considering with your doctor. 

Amino acids. Amino acids, such as acetyl-L-carnitine, may help improve peripheral neuropathy in people who have undergone chemotherapy and in people with diabetes. Side effects may include nausea and vomiting. 

Fish oil. These supplements, which have omega-3 fatty acids, may reduce inflammation, improve blood flow and improve neuropathy symptoms in people with diabetes. Check with your doctor before taking fish oil supplements if you’re taking anti-clotting medications.