Isosorbide
Spray On the Feet Reduces Neuropathic Pain in Diabetics
Spraying
the feet with an aerosolized form of isosorbide dinitrate (ISDN)
appears to provide temporary relief of diabetic neuropathy pain.
That,
according to the results of a small pilot study conducted in the UK.
Although
questions remain about the exact cause of diabetic neuropathy, experts
believe that the condition is related to impaired nitric oxide (NO)
generation. ISDN is a well known NO donor with potent vasodilating
properties.
Previously,
Dr. Kevin C. J. Yuen, from Addenbrooke's Hospital in Cambridge, and
colleagues found that topical application of ISDN appeared to reduce
the severity of symptoms associated with diabetic neuropathy.
In
the current study, the researchers evaluated the effectiveness of an
aerosolized form of ISDN in 22 people with diabetic neuropathy. The
patients were instructed to use the spray on both feet each night
before bedtime.
Half
of the group used ISDN spray for 1 month while the other half used an
inactive placebo spray. At the end of the month, the groups went 2
weeks with no treatment and then switched to the other treatment
regimen for another month. The findings are published in the October
issue of Diabetes Care.
Overall,
pain and burning sensations were reduced more when patients used the
ISDN spray than when they used the placebo, the report indicates. Two
patients developed mild headaches when using the ISDN spray, but the
headaches resolved and the patients continued therapy.
"At
study completion, 11 patients (50%) reported benefit and wished to
continue using the ISDN spray, 4 (18%) preferred the placebo spray and
the remaining 7 (32%) were undecided," the authors write.
Dr.
Yuen's team also found that patients reported improvements in sleep,
mobility and mood when using the ISDN spray.
"Some
patients reported an increased exercise threshold, and one patient
reported uninterrupted sleep at night, something she had not
experienced for several years because of her painful neuropathy,"
according to the report.
Still,
the investigators are calling for larger studies to confirm their
findings. The drug's effect may only be short-lived or it may not work
for all diabetic patients with the condition. Diabetes
Care 2002;25:1699-1703.
