Pajouhi M, Shaban Nejad Khas Z, Mohajeri Tehrani M R,
Volume 65, Issue 3 (6-2007)
Abstract
Background: Diabetic neuropathy is an incapacitating disease that afflicts almost 50 percent of patients with diabetes. A late finding in type 1 diabetes, diabetic neuropathy can be an early finding in non insulin-dependent diabetes. Diabetic neuropathies are divided primarily into two groups, sensorimotor and autonomic. Patients may acquire only one type of diabetic neuropathy or may present with combinations of neuropathies, such as autonomic neuropathy or distal symmetric polyneuropathy, the latter of which the most common form. Motor deficits, orthostatic hypotension, silent cardiac ischemia, hyperhidrosis, vasomotor instability, gastroparesis, bladder dysfunction, and sexual dysfunction can also result from diabetic neuropathy. Strict control of blood sugar, combined with proper daily foot care, is essential to avoid the complications of this disorder. With the potential to afflict any part of the nervous system, diabetic neuropathy should be suspected in all patients with type 2 diabetes as well as patients who have had type 1 diabetes for over five years. Although some patients with diabetic neuropathy notice few symptoms, upon physical examination mild to moderately severe sensory loss may be noted by the physician. Idiopathic neuropathy has been known to precede the onset of type 2 diabetes.
Hadi Gharebaghian, Mehri Amiri, Sepideh Seydi,
Volume 81, Issue 3 (6-2023)
Abstract
Background: Diabetes is the most common cause of peripheral neuropathy throughout the world and has negative impact on patient's quality of life. There is no cure and to date several drugs have been used for its symptomatic treatment, including antidepressants and antiepileptics. Neurotec is a herbal medicine (combination of wild star anise, nettle and tansy) that can be potentially effective in the treatment of this disorder. Proposed mechanisms include its effects on increasing nerve conduction velocity and repairing peripheral nerves.
Methods: In a single-blind randomized clinical trial from April to September 2018 in Kermanshah of patients referred to Taleghani Hospital Clinic, 100 diabetic patients with sensory complaints, were randomly divided into two groups. The first group received 100 to 300 mg gabapentin (a well-known effective antiepileptic drug) daily and the second group received 100 mg Neurotec daily. At the beginning of the study and at the weeks of 6 and 12, patients were evaluated with DN4 questionnaire and the visual analog scale (VAS) for severity of sensory symptoms including paresthesia and numbness and the results were compared and analyzed. In each serial visit, possible drug side effects were asked from patients and recorded.
|
Results: Neurotec reduced the feeling of coldness, pain, paresthesia and numbness VAS and DN4 scores (P of 0.01,0.05, 0.05, 0.05, 0.001, 0.05 respectively). Neurotec showed a significant advantage over gabapentin in reducing pain intensity and in other parameters the difference between the two groups was not significant. The only significant complication of Neurotec was dyspepsia that could be minimal in patients who receive the drug after a meal. Conversely in the gabapentin group, dizziness, drowsiness, and vertigo were significantly more common (P>0.05).
Conclusion: Neurotec can be useful for sensory symptoms of diabetic neuropathy. Its effect on symptomatic therapy is comparable to gabapentin or even better for painful diabetic neuropathies. Its proposed mechanism in neuronal repair needs to be evaluated and can be a potential advantage over symptomatic therapies. Neurotic has no serious side effects.
|
