Vitamin D for the treatment of painful diabetic neuropathy

Abdul Basit; Khalid Abdul Basit; Asher Fawwad; Fariha Shaheen; Nimra Fatima; Ioannis N Petropoulos; Uazman Alam; Rayaz A Malik

doi:10.1136/bmjdrc-2015-000148

Vitamin D for the treatment of painful diabetic neuropathy

BMJ Open Diabetes Res Care. 2016 Feb 10;4(1):e000148. doi: 10.1136/bmjdrc-2015-000148. eCollection 2016.

Authors

Abdul Basit¹, Khalid Abdul Basit², Asher Fawwad¹, Fariha Shaheen², Nimra Fatima², Ioannis N Petropoulos³, Uazman Alam⁴, Rayaz A Malik⁵

Affiliations

¹ Baqai Institute of Diabetology and Endocrinology, Karachi, Pakistan; Baqai Medical University, Karachi, Pakistan.
² Baqai Institute of Diabetology and Endocrinology , Karachi , Pakistan.
³ Weill Cornell Medicine-Qatar, Qatar Foundation , Doha , Qatar.
⁴ Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and the Manchester Royal Infirmary, Central Manchester Hospital Foundation Trust , Manchester , UK.
⁵ Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar; Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and the Manchester Royal Infirmary, Central Manchester Hospital Foundation Trust, Manchester, UK.

Abstract

Objective: To assess the effect of high-dose vitamin D in patients with painful diabetic neuropathy.

Methods: A single intramuscular dose of 600 000 IU vitamin D was administered, and the effects on metabolic parameters and neuropathic pain assessed over 20 weeks.

Results: 143 participants with predominantly type 2 diabetes, aged 52.31±11.48 years, with a Douleur Neuropathique 4 (DN4) score (3.0±1.8), total McGill pain score (21.2±14.9), and Short Form McGill Pain Questionnaire (SFMPQ) score (2.1±0.9), were enrolled. The baseline 25-hydroxyvitamin D (25(OH)D) level was 31.7±23.3 ng/mL and 58 (40.5%) patients showed evidence of vitamin D deficiency (25(OH)D<20 ng/mL). Intramuscular administration of vitamin D resulted in a significant increase in 25(OH)D (46.2±10.2 ng/mL, p<0.0001) and a reduction in positive symptoms on the DN4 (p<0.0001), total pain score (p<0.0001), and SFMPQ (p<0.0001).

Conclusions: Treatment with a single intramuscular dose of 600 000 IU of vitamin D in patients with painful diabetic neuropathy is associated with a significant decrease in the symptoms of painful diabetic neuropathy.

Trial registration number: BIDE-12/2014.

Keywords: Neuropathy Complications; Neuropathy and Clinical Diabetes; Pain; Vitamin D.