Dietary and Nutritional Supplementation for Painful Diabetic Neuropathy: A Narrative Review

Abstract

Painful diabetic neuropathy (PDN) is a serious and very common complication of diabetes mellitus (DM). It negatively affects the quality of life, increases morbidity and poses a financial burden on the health care system. Currently, treatment of PDN focuses on glycaemic control, while pathogenesis-oriented therapy has not yielded satisfactory results. The need to improve therapy remains. There is accumulating evidence on the potential benefit of nutritional interventions. This narrative review aims to examine the potential benefit of dietary and nutritional supplementation for PDN management. According to the preliminary research, supplementation with vitamin E, B-complex, omega-3 fatty acids, CoQ10 or N-acetylcysteine seems to be associated with promising results in improving PDN symptoms.

Key words

diabetes mellitus - diet - nutrition - painful diabetic neuropathy - supplement

Publikationsverlauf

Eingereicht: 06. Juni 2023
Eingereicht: 30. September 2023

Angenommen: 06. Oktober 2023

Accepted Manuscript online:
09. Oktober 2023

Artikel online veröffentlicht:
06. Dezember 2023

• References

• 1 Ziegler D, Keller J, Maier C. et al. Diabetic neuropathy. Exp Clin Endocrinol Diabetes 2023; 131: 72-83
• 2 Sloan G, Shillo P, Selvarajah D. et al. A new look at painful diabetic neuropathy. Diabetes Res Clin Pract 2018; 144: 177-191
• 3 Ziegler D, Papanas N, Schnell O. et al. Current concepts in the management of diabetic polyneuropathy. J Diabetes Investig 2021; 12: 464-475
• 4 Yagihashi S, Mizukami H, Sugimoto K. Mechanism of diabetic neuropathy: Where are we now and where to go?. J Diabetes Investig 2011; 2: 18-32
• 5 Zilliox LA, Russell JW. Physical activity and dietary interventions in diabetic neuropathy: A systematic review. Clin Auton Res 2019; 29: 443-455
• 6 Ziegler D, Porta M, Papanas N. et al. The role of biofactors in diabetic microvascular complications. Curr Diabetes Rev 2022; 18: e250821195830
• 7 Bril V, England J, Franklin GM. et al. Evidence-based guideline: Treatment of painful diabetic neuropathy: report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation. Neurology 2011; 76: 1758-1765
• 8 Le Y, Wang B, Xue M. Nutraceuticals use and type 2 diabetes mellitus. Curr Opin Pharmacol 2022; 62: 168-176
• 9 Page MJ, McKenzie JE, Bossuyt PM. et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021 372. 71
• 10 Papanas N, Ziegler D. Efficacy of α-lipoic acid in diabetic neuropathy. Expert Opin Pharmacother 2014; 15: 2721-2731
• 11 Han T, Bai J, Liu W. et al. A systematic review and meta-analysis of α-lipoic acid in the treatment of diabetic peripheral neuropathy. Eur J Endocrinol 2012; 167: 465-471
• 12 Abubaker SA, Alonazy AM, Abdulrahman A. Effect of alpha-lipoic acid in the treatment of diabetic neuropathy: A systematic review. Cureus 2022; 14: e25750
• 13 Durán AM, Beeson WL, Firek A. et al. Dietary omega-3 poly unsaturated fatty-acid supplementation up regulates protective cellular pathways in patients with type 2 diabetes exhibiting improvement in painful diabetic neuropathy. Nutrients 2022; 14: 761
• 14 Ahmad A, Asif SJ, Mushtaq S. et al. Effect of replacement of vit-D in diabetic painful neuropathy among chronic type 2 diabetic patients. J Islamabad Med Dent Coll 2022; 11: 77-81
• 15 Pinzon RT, Wijaya VO, Veronica V. The benefits of add-on therapy of vitamin D 5000 IU to the vitamin D levels and symptoms in diabetic neuropathy patients: A randomized clinical trial. J Pain Res 2021; 14: 3865-3875
• 16 Putz Z, Tordai D, Hajdú N. et al. Vitamin D in the prevention and treatment of diabetic neuropathy. Clin Ther 2022; 44: 813-823
• 17 Davoudi M, Allame Z, Niya RT. et al. The synergistic effect of vitamin D supplement and mindfulness training on pain severity, pain-related disability and neuropathy-specific quality of life dimensions in painful diabetic neuropathy: A randomized clinical trial with placebo-controlled. J Diabetes Metab Disord 2021; 20: 49-58
• 18 Yammine K, Wehbe R, Assi C. A systematic review on the efficacy of vitamin D supplementation on diabetic peripheral neuropathy. Clin Nutr 2020; 39: 2970-2974
• 19 Karonova T, Stepanova A, Bystrova A. et al. High-dose vitamin D supplementation improves microcirculation and reduces inflammation in diabetic neuropathy patients. Nutrients 2020; 12: 2518
• 20 Ghadiri-Anari A, Mozafari Z, Gholami S. et al. Dose vitamin D supplementations improve peripheral diabetic neuropathy? A before-after clinical trial. Diabetes Metab Syndr 2019; 13: 890-893
• 21 Alam U, Fawwad A, Shaheen F. et al. Improvement in neuropathy specific quality of life in patients with diabetes after vitamin D supplementation. J Diabetes Res 2017; 2017: 7928083
• 22 Basit A, Basit KA, Fawwad A. et al. Vitamin D for the treatment of painful diabetic neuropathy. BMJ Open Diabetes Res Care 2016; 4: e000148
• 23 Shehab D, Al-Jarallah K, Abdella N. et al. Prospective evaluation of the effect of short-term oral vitamin D supplementation on peripheral neuropathy in type 2 diabetes mellitus. Med Princ Pract 2015; 24: 250-256
• 24 Lv WS, Zhao WJ, Gong SL. et al. Serum 25-hydroxyvitamin D levels and peripheral neuropathy in patients with type 2 diabetes: A systematic review and meta-analysis. J Endocrinol Invest 2015; 38: 513-518
• 25 Amini P, Sajedi F, Mirjalili M. et al. Coenzyme Q10 as a potential add-on treatment for patients suffering from painful diabetic neuropathy: Results of a placebo-controlled randomized trial. Eur J Clin Pharmacol 2022; 78: 1899-1910
• 26 Khalil H, Ang CD, Khalil V. Vitamin B for treating diabetic peripheral neuropathy - A systematic review. Diabetes Metab Syndr 2021; 15: 102213
• 27 Essa NS, Aladul MI. Role of neurotropic B vitamins in the treatment of diabetic neuropathy: Narrative review. Iraqi. J Pharm 2022; 19: 98-111
• 28 Karaganis S, Song XJ. B vitamins as a treatment for diabetic pain and neuropathy. J Clin Pharm Ther 2021; 46: 1199-1212
• 29 Wang D, Zhai JX, Liu DW. Serum folate, vitamin B12 levels and diabetic peripheral neuropathy in type 2 diabetes: A meta-analysis. Mol Cell Endocrinol 2017; 443: 72-79
• 30 Didangelos T, Karlafti E, Kotzakioulafi E. et al. Vitamin B12 Supplementation in diabetic neuropathy: A 1-year, randomized, double-blind, placebo-controlled trial. Nutrients 2021; 13: 395
• 31 Mottaghi T, Khorvash F, Maracy M. et al. Effect of folic acid supplementation on nerve conduction velocity in diabetic polyneuropathy patients. Neurol Res 2019; 41: 364-368
• 32 Didangelos T, Karlafti E, Tziomalos K. et al. Improvement in painful diabetic neuropathy after 3 months from administration of a supplement containing SOD, ALA, B12 and Carnitine. In, Diabetologia. New York: Springer; 2018: S34-S34
• 33 Park K, Kim Y, Kim J. et al. Supplementation with Korean red ginseng improves current perception threshold in Korean type 2 diabetes patients: A randomized, double-blind, placebo-controlled trial. J Diabetes Res 2020; 2020: 5295328
• 34 Asadi S, Gholami MS, Siassi F. et al. Nano curcumin supplementation reduced the severity of diabetic sensorimotor polyneuropathy in patients with type 2 diabetes mellitus: A randomized double-blind placebo- controlled clinical trial. Complement Ther Med 2019; 43: 253-260
• 35 Boyd A, Bleakley C, Hurley DA. et al. Herbal medicinal products or preparations for neuropathic pain. Cochrane Database Syst Rev 2019; 4: CD010528
• 36 Storz MA, Küster O. Plant-based diets and diabetic neuropathy: A systematic review. Lifestyle Medicine 2020; 1: e6
• 37 Bunner A, Wells C, Gonzales J. et al. A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study. Nutr Diabetes 2015; 5: e158-e158
• 38 Heidari N, Sajedi F, Mohammadi Y. et al. Ameliorative effects of N-acetylcysteine as adjunct therapy on symptoms of painful diabetic neuropathy. J Pain Res 2019; 3147-3159
• 39 Ng YT, Phang SCW, Tan GCJ. et al. The effects of tocotrienol-rich vitamin E (Tocovid) on diabetic neuropathy: A phase II randomized controlled trial. Nutrients 2020; 12: 1522
• 40 Hor CP, Fung WY, Ang HA. et al. Efficacy of oral mixed tocotrienols in diabetic peripheral neuropathy: A randomized clinical trial. JAMA Neurol 2018; 75: 444-452
• 41 Rajanandh MG, Kosey S, Prathiksha G. Assessment of antioxidant supplementation on the neuropathic pain score and quality of life in diabetic neuropathy patients – a randomized controlled study. Pharm Rep 2014; 66: 44-48
• 42 Karakousis ND, Pyrgioti EE, Georgakopoulos PN. et al. Magnesium and diabetic foot ulcers: A mini review. Int J Low Extrem Wounds 2023; 15347346231176117
• 43 Apergi K, Dimosthenopoulos C, Papanas N. The role of nutrients and diet characteristics in the management of diabetic foot ulcers: A systematic review. [published online ahead of print, 2023 Feb 3]. Int J Low Extrem Wounds 2023; 15347346231153531
• 44 Vas PRJ, Edmonds ME, Papanas N. Nutritional supplementation for diabetic foot ulcers: The big challenge. Int J Low Extrem Wounds 2017; 16: 226-229