February 13, 2006

Intensive therapy relieves diabetes neuropathy

NEW YORK (Reuters Health) - Several years after
participating in a clinical trial of intensive diabetes
therapy, patients assigned this treatment still showed
improvements in neuropathy symptoms, according to a report
Diabetes Care.

The study involved 1,257 subjects who were enrolled in the
Diabetes Control and Complications Trial who were randomly
assigned to receive intensive or conventional diabetes therapy.
The intensive approach involved at least three injections of
insulin per day, while the conventional approach involved no
more than two.

After being followed for an average of 6.5 years, all of
the subjects were encouraged to use the intensive therapy. The
patients were then evaluated annually for neuropathy and other

Consistent with what was seen before, the group initially
assigned to receive intensive therapy had a lower prevalence of
neuropathy than those who began with conventional therapy: 17.8
percent vs. 28.0 percent, based on physical examination,
Catherine L. Martin and colleagues, from the DCCT/EDIC Research
Group in Bethesda, Maryland, note.

Signs and symptoms of neuropathy were also less common in
the first intensive therapy group, even though patients' blood
sugar levels were comparable to those seen in the conventional
therapy group.

Patients who received intensive therapy were 64 percent and
45 percent less likely to have symptoms and signs,
respectively, of neuropathy compared with those who received
conventional therapy. This benefit persisted for at least 8
years after the end of treatment.

The relationship between blood sugar control and neuropathy
suggests that intensive therapy has a durable effect on
neuropathy similar, similar to what has previously been
reported for diabetic eye disease and kidney disease, the
authors conclude.

SOURCE: Diabetes Care February 2006.