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Question re my mom's leg pain due to diabetic neuropathy

Discussion in 'Adults with Type 2' started by Pavlos, Aug 31, 2009.

  1. Pavlos

    Pavlos Approved members

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    Hi guys.

    My mother has been treated for T2 for the past 15 years or so, and her control has, alas, not been best. My increased awareness about diabetes, following my daughter's dx as a T1 two years ago, has helped me guide her to controlling her diabetes more effectively.

    I am afraid my mom is experiencing complications with legs - diabetic neuropathy, which is making it very painful to walk. Her doc here in Greece advised her to walk a lot, quit smoking and lose weight (which has been my advice to het over the past 30 years!) but did to prescribe something that would alleviate the leg pain when she walks. So it is a bit of a catch-22 situation, she cannot walk to improve the condition of her legs because of the pain.

    What is the first-line treatment for pain caused by diabetic neuropathy in the legs in the US? I would really appreciate any practical advice you could offer in this regard.

    Thanks!
     
  2. deafmack

    deafmack Approved members

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    You may want to post over on the type 2 boards on the American Diabetes
    Website at http://www.diabetes.org
    There are a great group of people over there. They have a lot of great advice in dealing with type 2 and you are certainly welcome over there.
     
  3. Ellen

    Ellen Senior Member

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    I would research at pubmed (http://www.ncbi.nlm.nih.gov/pubmed/) and other sources (in Germany too) about Benfotiamine and neuropathy. I don't know why that research has not gotten sufficient attention in the US. I think in many ways Europe is more advanced in looking beyond big pharma for safe, affordable and effective solutions.

    Here's one:
    Int J Clin Pharmacol Ther. 2005 Feb;43(2):71-7.Links
    Erratum in:
    Int J Clin Pharmacol Ther. 2005 Jun;43(6):304.
    Benfotiamine in the treatment of diabetic polyneuropathy--a three-week randomized, controlled pilot study (BEDIP study).

    Haupt E, Ledermann H, K?pcke W.
    Saale-Klinik, Bad Kissingen, Lindenfels, Germany. BfA.Saaleklinik@t-online.de
    OBJECTIVE: The aim of the study was to evaluate the efficacy of benfotiamine administered over three weeks (allithiamine; a lipid-soluble vitamin B1 prodrug with high bioavailability) to patients with diabetic polyneuropathy in a randomized, placebo-controlled, double-blind, two-center pilot study. MATERIAL AND METHODS: Forty inpatients (23 male, 18 female, age range 18 - 70 years) with a history of type 1 or 2 diabetes and polyneuropathy of not longer than two years, were included in the study. Twenty Patients received two 50 mg benfotiamine tablets four times daily and 20 patients received placebo over the three-week study period. Two clinical units were involved with 10 patients receiving placebo and 10 patients benfotiamine in each. The neuropathy score according to Katzenwadel et al. [1987] was used to evaluate symptoms of polyneuropathy, vibration perception threshold and both the physician's and the patient's own assessment were documented. RESULTS: A statistically significant (p = 0.0287) improvement in the neuropathy score was observed in the group given active drug when compared to the placebo-treated controls. There was no statistically significant change observed in the tuning fork test. The most pronounced effect on complaints was a decrease in pain (p = 0.0414). More patients in the benfotiamine-treated group than in the placebo group considered their clinical condition to have improved (p = 0.052). No side effects attributable to benfotiamine were observed. The differences between the groups cannot be attributed to a change in metabolic parameters since there were no significant alterations in the HbA1 levels and blood sugar profiles. The body mass index of the two groups did not differ. CONCLUSION: This pilot investigation (BEDIP Study) has confirmed the results of two earlier randomized controlled trials and has provided further evidence for the beneficial effects of benfotiamine in patients with diabetic neuropathy.

    Here's just one old abstract:

    Arzneimittelforschung. 1999 Mar;49(3):220-4.Links
    Effectiveness of different benfotiamine dosage regimens in the treatment of painful diabetic neuropathy.

    Winkler G, P?l B, Nagyb?ganyi E, Ory I, Porochnavec M, Kempler P.
    2nd Department of Internal Medicine, Municipal St. John's Hospital, Budapest, Hungary.
    The therapeutic effectiveness of a benfotiamine (CAS 22457-89-2)-vitamin B combination (Milgamma-N), administered in high (4 x 2 capsules/day, = 320 mg benfotiamine/day) and medium doses (3 x 1 capsules/day), was compared to a monotherapy with benfotiamine (Benfogamma) (3 x 1 tablets/day, = 150 mg benfotiamine/day) in diabetic patients suffering from painful peripheral diabetic neuropathy (DNP). In a 6-week open clinical trial, 36 patients (aged 40 to 70 yrs) having acceptable metabolic control (HbA1c < 8.0%) were randomly assigned to three groups, each of them comprising 12 participants. Neuropathy was assessed by five parameters: the pain sensation (evaluated by a modified analogue visual scale), the vibration sensation (measured with a tuning fork using the Riedel-Seyfert method) and the current perception threshold (CPT) on the peroneal nerve at 3 frequencies: 5, 250 and 2000 Hz). Parameters were registered at the beginning of the study and at the end of the 3rd and 6th week of therapy. An overall bneneficial therapeutic effect on the neuropathy status was observed in all three groups during the study, and a significant improvement in most of the parameters studied appeared already at the 3rd week of therapy (p < 0.01). The greatest change occurred in the group of patients receiving the high dose of benfotiamine (p < 0.01 and 0.05, resp., compared to the othr groups). Metabolic control did not change over the study. It is concluded that benfotiamine is most effective in large doses, although even in smaller daily dosages, either in combination or in monotherapy, it is effective.
     
  4. Pavlos

    Pavlos Approved members

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    Deafmack and Ellen thank you very much for your feedback :)
     
  5. Pavlos

    Pavlos Approved members

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    :) Update: My mother has been taking Benfotiamine for over a month now. She is feeling much less leg-pain and can walk greater distances!

    She asked me to thank you for the advice :)
     
  6. deafmack

    deafmack Approved members

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    I am glad we were able to help. A lot of people use Alpha Lipoic Acid as well as it seems to get to the underlying cause of neuropathy and works well also.
     

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