A systematic review on the efficacy of vitamin D supplementation on diabetic peripheral neuropathy

Yammine, Kaissar; Wehbe, Rudy; Assi, Chahine

doi:10.1016/j.clnu.2020.01.022

Cited by 41 publications

(33 citation statements)

References 18 publications

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“…These findings are in agreement with our results that showed improvement in rest HRV parameters in response to short interventional treatment, as opposed to dynamic tests that remained unchanged. Some cross-sectional studies and a recent systematic review suggest an association between vitamin D serum level, presence and severity of peripheral neuropathies in patients with diabetes (7)(8)(9)(10)(11). In addition, Jung et al (10) and Da Silva et al (12) showed an association between VD and rest parameters of CAN in this population.…”

Section: Discussionmentioning

confidence: 84%

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Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

et al. 2020

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BackgroundCardiovascular autonomic neuropathy (CAN) is associated with diabetes mellitus, increasing morbidity and mortality. Some cross-sectional studies associated CAN with low 25-hydroxyvitamin D levels. The aim of our study was to evaluate the effect of high-dose vitamin D (VD) supplementation on CAN in Type 1 Diabetes Mellitus (T1DM) patients.MethodsWe performed a prospective study with 23 patients diagnosed with T1DM and CAN. Subjects with VD levels <30 ng/ml received 10,000 IU/day; the ones with VD levels between 30–60 ng/ml were given 4,000 IU/day for 12 weeks.ResultsThere was an improvement in CAN parameters related to resting heart rate variability, such as time domain parameters [Maximum RR interval (0.77 ± 0.11 vs 0.94 ± 0.51 s, p <0.05), Mean length of regular RR intervals (0.71 ± 0.10 vs 0.76 ± 0.09 s, p <0.05) and Standard deviation of all NN intervals (0.02 ± 0.01 vs 0.03 ± 0.02 s; p <0.01)] and frequency domain parameters [Low Frequency (1.9 ± 0.5 vs 2.5 ± 0.9 s, p < 0.001), Total Power (2.5 ± 0.4 vs 2.8 ± 0.6 s, p <0.05)]. In addition, there was a correlation between absolute VD level variation and posttreatment High Frequency (%), as well as among percent variation in VD level and end-of-study Low Frequency/High Frequency ratio (r=0.6, p<0.01; r= -0.5, p<0.05, respectively).ConclusionOur pilot study is the first to suggest a strong association between high-dose vitamin D supplementation and improved cardiovascular autonomic neuropathy in T1DM patients. It occurred without any variation in HbA1C, blood pressure levels, lipids, and insulin dose.Clinical Trial Registrationhttp://www.isrctn.com/ISRCTN32601947, identifier ISRCTN32601947.

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Section: Discussionmentioning

confidence: 84%

“…Few cross-sectional studies suggest an association between 25 (OH)D level, presence and severity of peripheral neuropathies (7)(8)(9)(10)(11) and CAN (10,12) in patients with diabetes (7)(8)(9)(10)(11). Nevertheless, there are no data available about the effect of high doses of VD supplementation on CAN in people with T1DM (13,14).…”

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confidence: 99%

Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

et al. 2020

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“…In a study from Pakistan 141 patients with pDPN received a single high dose of intramuscular vitD3 (cholecalciferol 600,000IU) which resulted in ~70% reduction in pain scores [117] with additional improvements in quality of life (QoL), wellbeing and reduced emotional distress [125]. A recent meta-analysis showed an improvement in pain scores in favour of vitamin D supplementation (1.14 (95% CI = 1.22 to 1.67, p<0.0001) [126]. A large-scale RCT is required to determine the place of vitamin D in the treatment of pDPN.…”

Section: Vitamin Dmentioning

confidence: 99%

State-of-the-art pharmacotherapy for diabetic neuropathy

Azmi

Alam

Burgess

et al. 2020

Expert Opinion on Pharmacotherapy

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Introduction: The global epidemic of diabetes has led to an epidemic of diabetes complications. Diabetic neuropathy is the most common microvascular complication, of which diabetic peripheral neuropathy (DPN) and autonomic neuropathy (AN) are the most prevalent, affecting ~50% of patients. DPN results in pain with a poor quality of life and a loss of sensation with an increased risk of foot ulceration. Autonomic neuropathy can cause significant morbidity in a minority and is associated with increased mortality. The cornerstone of treatment to prevent or limit the progression of DPN/AN is multifactorial risk factor modification including treatment of glycemia, lipids and blood pressure. Whilst, there are no FDA-approved disease-modifying therapies, there are a number of therapies to relieve symptoms in DPN and AN. Areas covered: The authors discuss current approved therapies for painful diabetic neuropathy and autonomic neuropathy. They also address the potential role of improving risk factors to limit the development and progression of diabetic neuropathy and new pathogenetic and pain-relieving treatments. Expert opinion: The FDA-approved Pregabalin and Duloxetine over 25 years ago and Tapentadol, 6 years ago for painful diabetic neuropathy. There are currently no FDA-approved disease-modifying treatments for diabetic neuropathy which has been attributed to inappropriate models of the disease with limited translational capacity and major limitations of trial designs and endpoints in clinical trials.

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“…5 Hypovitaminosis D may cause neurological deficits involving both the peripheral and central nervous systems . 6,7 Hypovitaminosis D is highly prevalent in patients with type 2 diabetes mellitus. 6 The degree of hypovitaminosis D correlates well with the severity of diabetic neuropathy 6 involving both large 8 and small 5 In contrast to thiamine, pyridoxine, cobalamin, folate, and vitamin E, there is a paucity of evidence to conclude that isolated LETTERS TO THE EDITOR E89…”

Section: To the Editormentioning

confidence: 99%

Neuropathies and vitamin D deficiency

Luo

Dun

2020

Muscle and Nerve

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Randomized placebo-control trials of administrating either a topical compound containing vitamin D or oral open-label vitamin D 3 in patients with diabetic peripheral neuropathy demonstrated significant therapeutic benefits. 6 Vitamin D promotes axon regeneration and remyelination following nerve injury by modulating production of neurotrophins such as nerve growth factor. Nerve growth factor is necessary for sympathetic and sensory neuron survival and development. 9 Recognition of vitamin D deficiency is important in the management of nutritional neuropathies. Importantly, supplementation of vitamin D to patients with vitamin D deficiency may alleviate neuropathic symptoms and have the potential to arrest, and perhapsreverse, 6-9 the progression of hypovitaminosis D-related neuropathy. DISCLOSURE Dr. Luo reports no disclosures. Dr. Dun reports no disclosures. ETHICAL PUBLICATION STATEMENT We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

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A systematic review on the efficacy of vitamin D supplementation on diabetic peripheral neuropathy

Cited by 41 publications

References 18 publications

Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

Improvement in Cardiovascular Autonomic Neuropathy After High-Dose Vitamin D Supplementation in Patients With Type 1 Diabetes

State-of-the-art pharmacotherapy for diabetic neuropathy

Neuropathies and vitamin D deficiency

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