Endocrine Abstracts

Diabetic peripheral neuropathy (DPN) is the most common cause of neuropathy worldwide, its prevalence increases with diabetes duration (DD). About 60%-70% diabetic patients will eventually develop DPN. Vitamin B12/D (VitB12/D) deficiency is a global public health problem. Around 29.66% of diabetic patients have confirmed B12 insufficiency. Patients on Metformin have statistically lower values of B12 (P= 0.01). Vitamin D deficiency is considered to be a contributing factor to the development of type 2 diabetes (T2DM).Our aim was to study the effect of VitB12/D therapy in patient with T2DM and DPN.

Methods: Totally 52 patients were studied (27 males/33 females, mean age 51±5yrs, DD - 5-10 years, HbA1c at entry - 8,3±1,5%). Before initiating treatment with VitB12/D below tests were performed and following results were obtained: Vitamin B12 (150±20pg/mL [n - 200-835 pg/mL]), Vitamin D (15±25 ng/m [n - 30-100 ng/ml]); all neurological tests (10-g monofilament test, tip-term/temperature test, vibration test with the 128-Hz tuning fork, prick tests) were positive, and neurological examination with Sudoscan (a non–invasive method for the assessment of the small fiber function, Impeto Medical, France) revealed presence of mild small fiber neuropathy. Treatment with oral VitB12/D was initiated in all the patients.

Results: At month 3 post treatment initiation all tests were repeated. In 88% of patients VitB12/D levels were within the normal range; results of monofilament, tip-term/ temperature test and Sudoscan examination improved in 41 patients (78,5%).

Conclusion: This study shows that 3-month treatment with VitB12/D improves condition of peripheral nerve fibers. Observations will continue.