Intensive Therapy Relieves Diabetes Neuropathy

Patients who received intensive therapy were 64 percent less likely to have symptoms and signs, respectively, of neuropathy. Several years after participating in a clinical trial of intensive diabetes therapy, patients assigned to this treatment still showed improvements in neuropathy symptoms.

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 complications.

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.
Diabetes Care February 2006.

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