Effect of folic acid supplementation on nerve conduction velocity in diabetic polyneuropathy patients

Mottaghi, Tayebeh; Khorvash, Fariborz; Maracy, Mohammadreza; Bellissimo, Nick; Askari, Gholamreza

doi:10.1080/01616412.2019.1565180

Cited by 23 publications

(16 citation statements)

References 28 publications

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“…These results showed that a better glucose regulation may reduce the risk of PNP and DFC development in diabetic patients. The data of the previous studies showed that elderly age, male sex, impaired glycemic control, and increased diabetes duration are the risk factors for the diabetic foot development (11,12). In our study, patients with diabetic foot were in the elderly age group and male ratio was higher.…”

Section: Discussionsupporting

confidence: 46%

The effectiveness of electroneuromyography in the early diagnosis of diabetic foot development

Can¹,

Bilge²,

Alay³

et al. 2021

Journal of Health Sciences and Medicine

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Objective: Diabetic foot is one of the basic causes of lower extremity amputation. The aim of this study is to determine which examination method of nerve conduction disorders may be used predominantly for early diagnosis of diabetic foot development in the follow-up of diabetic patients. Material and Method:The study consists of 3 different groups (n=150) of patients diagnosed with type 2 diabetes (DM). Group 1; 50 patients with diabetic foot complications (DFC+), Group 2; 50 patients without diabetic foot complications and with polyneuropathy (DFC-/PNP+), Group 3; 50 patients without diabetic foot complications and without polyneuropathy (DFC-/PNP-). Diabetic foot wounds were grouped by PEDIS classification. A total of 150 DM patients were included. The age, sex, diabetes duration, blood glucose levels, HbA1c measurements, and standard electroneuromyography (ENMG) findings were compared. Findings: Age, sex, diabetes duration, blood glucose, HbA1c values and electroneuromyography (ENMG) for nerve amplitude, velocity and latency results were compared among the groups. A significant statistical difference was found between three groups when age, sex, HgbA1c, fasting blood glucose, diabetes duration was evaluated (p<0.05). All DFC+ patients had PNP+. In the DFC+ group, unlike DFC-/PNP+ group, the motor nerves of the lower extremities were also involved. Tibial nerve velocity was lower than normal in DFC+ patients and normal in other groups (p<0.05). A statistically significant difference was found in peroneal nerve conduction velocity between the DFC+ group and the DFC-groups (p<0.05). Peroneal nerve conduction velocity was not statistically significant between DFC-/PNP+ and DFC-/PNP-groups (p>0.05). Peroneal nerve conduction velocity was lowest in the DFC+ group. This factor was considered as a risk factor for DFC development. Conclusions:The slowdown in peroneal nerve conduction velocity and the increase in diabetes duration were the primary risk factors for diabetic foot development, and the decrease in tibial nerve velocity was also considered as significant. This study showed that the involvement of motor nerve conduction in the lower extremity was considered as a signal for diabetic foot development.

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Section: Discussionsupporting

confidence: 46%

The effectiveness of electroneuromyography in the early diagnosis of diabetic foot development

Can¹,

Bilge²,

Alay³

et al. 2021

Journal of Health Sciences and Medicine

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“…Another study in which vitamin B12 supplementation was performed in patients with diabetic neuropathy found no conclusive evidence regarding improvement of neuropathy symptoms (31). Interestingly, folic acid supplementation does appear to have a positive effect on diabetic neuropathy according to a recent study (32).…”

Section: Discussionmentioning

confidence: 94%

Vitamin B12 deficiency and diabetic neuropathy in patients taking metformin: a cross-sectional study

Alvarez

Sierra

Saavedra

et al. 2019

Endocrine Connections

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Objective Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. In this study, we aimed to evaluate the prevalence of vitamin B12 deficiency in patients with chronic metformin use and the relationship between vitamin B12 deficiency and diabetic neuropathy. Methods A cross-sectional study was conducted with 162 patients. Vitamin B12 levels were measured by chemiluminescence immunoassay. Diabetic neuropathy was evaluated by patient record, nerve conduction and Michigan test for the diagnosis of diabetic neuropathy. Additional data, including demographic characteristics were collected. A linear regression model was used to evaluate variables that correlated with vitamin B12 levels and diabetic neuropathy. Results Low vitamin B12 levels were found in 7.3% (95% CI: 4.0–12%) of patients. In those with diabetic neuropathy, altered (low and borderline) vitamin B12 level was 64% (95% CI: 47–78%) compared to 17% (95% CI: 10–26%) in patients without diabetic neuropathy (coefficient: −110.8; CI 95%: −165.8, −59.7). Those taking a higher metformin dose had lower levels of vitamin B12 (coefficient: −0.061; CI 95%: −0.09, −0.024). In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3–95). Conclusions Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12.

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“…One recent study 41 was found investigating folic acid (B9) as a monotherapy (Table 1). Overall results were highly positive, with numerous measures of motor nerve function showing improvement compared with baseline and placebo.…”

Section: Commentmentioning

confidence: 99%

B vitamins as a treatment for diabetic pain and neuropathy

Karaganis

Song

2021

J Clin Pharm Ther

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What is known and objective: B vitamin therapy is a common treatment for diabetic pain and neuropathy, yet its use remains controversial in patients lacking B vitamin deficiencies. The aim of this review was to summarize the current evidence for the efficacy of B vitamin therapy in diabetic patients with neuropathy. Comment:We screened the English literature for clinical studies evaluating B vitamins as a therapy for pain and neuropathy in diabetic patients. We selected 43 relevant studies for qualitative analysis based on our selection criteria. Our survey of the literature revealed substantive heterogeneity with respect to efficacies of reported outcomes, as well as study design. Most beneficial outcomes were reported against baseline measures, with few positive comparisons against placebo. This highlights the need for larger, placebo-controlled studies.What is new and conclusion: B vitamins should be considered a plausible therapy for diabetic neuropathy, but its overall efficacy remains uncertain and requires further study.

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Effect of folic acid supplementation on nerve conduction velocity in diabetic polyneuropathy patients

Cited by 23 publications

References 28 publications

The effectiveness of electroneuromyography in the early diagnosis of diabetic foot development

The effectiveness of electroneuromyography in the early diagnosis of diabetic foot development

Vitamin B12 deficiency and diabetic neuropathy in patients taking metformin: a cross-sectional study

B vitamins as a treatment for diabetic pain and neuropathy

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