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Single high-dose vitamin D injection may relieve painful diabetic neuropathy
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In patients with painful diabetic neuropathy, a single high-dose intramuscular injection of vitamin D appears to confer a significant reduction in symptoms, according to study data.
Rayaz A. Malik, MBChB, PhD, professor of medicine at Weill Cornell Medicine in Qatar, and colleagues evaluated 143 adults (mean age, 52 years) with type 1 or type 2 diabetes to determine the effect of a high-dose intramuscular injection of vitamin D (600,000 IU) on painful diabetic neuropathy. Participants were evaluated at baseline and on four subsequent visits every 5 weeks, with follow-up visits taking place at 4 to 6 weeks (visit 2), 8 to 12 weeks (visit 3), 14 to 16 weeks (visit 4) and 18 to 20 weeks (visit 5). At visit 1, participants received a single intramuscular dose of 600,000 IU of vitamin D.
Rayaz A. Malik
The baseline serum 25-hydroxyvitamin D concentration was 31.7 ng/mL and evidence of vitamin D deficiency (25-[OH]D < 20 ng/mL) was present in 40.5% of participants.
The researchers found that between visit 1 and visit 5, there was an increase in 25-(OH)D levels (from 31.7 ng/mL to 46.2 ng/mL; P < .0001). HbA1c also decreased from visit 1 to visit 5 (from 8.6% to 8.2%; P = .02), whereas there was an increase in HDL cholesterol (from 39 mg/dL to 43 mg/dL; P = .03); no change was found for total cholesterol or triglycerides. A small increase was found for serum calcium levels (P = .009).
A change in McGill pain index location was seen between visit 1 and visit 2 (P = .001) with further decreases at visit 3 (P < .0001), visit 4 (P < .0001) and visit 5 (P < .0001) vs. visit 1. Compared with visit 1, the McGill pain score decreased at visit 3 (P < .0001), visit 4 (P < .0001) and visit 5 (P < .0001).
No change in Douleur Neuropathique 4 score was observed between visit 1 and visit 2, 3, 4 or 5. However, a comparison of the positive symptoms of the Douleur Neuropathique 4 score revealed a reduction at visit 3 (P = .0005), visit 4 (P = .001) and visit 5 (P = .0003) compared with visit 1.
“Treatment options for [painful diabetic neuropathy] are currently limited due to side effects from many of the current therapies,” the researchers wrote. “We acknowledge that a major limitation of the current study is the lack of a placebo group. However, a single high-dose of intramuscular vitamin D appears to be a safe and effective treatment for [painful diabetic neuropathy].” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.
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