Why this matters
Findings warrant a well-constructed clinical trial of vitamin D in PDN to assess the effectiveness of a potentially simple treatment with no obvious side effects.
This study included 43 patients with type 1 diabetes (painless diabetic peripheral neuropathy [DPN; n=20] or PDN [n=23]) and 14 matched non-diabetic control participants.
Funding: Juvenile Diabetes Research Foundation and the National Institutes of Health.
No significant differences were seen for age, body mass index, haemoglobin A1c, lipids, neurological deficits, quantitative sensory testing, electrophysiology, intra-epidermal nerve fibre density and corneal confocal microscopy between the DPN and PDN groups.
Both positive (P=.009) and negative (P=.02) symptoms of diabetic neuropathy were significantly greater in patients with PDN vs. those with DPN.
McGill pain score and Visual Analogue Score were significantly greater in PDN vs DPN and controls (P<.0001 for both).
Neuropathy symptom profile was significantly higher in PDN vs DPN (P<.0005) and controls (P<.0001).
Serum 25(OH)D levels were significantly reduced in PDN (24.0±14.1 ng/mL) vs DPN (34.6±15.0 ng/mL; P=.01) and controls (34.1±8.6 ng/mL; P=.03).
Vitamin D deficiency (OR, 9.8; 95% CI, 2.2-76.4; P=.003) and insufficiency (OR, 4.4; 95% CI, 1.1-19.8; P=.03) were associated with an increased risk of PDN.
Small sample size.
Lack of quantification of sunlight exposure or daily activity and comparison with a non-neuropathic diabetic cohort.
Alam U, Petropoulos IN, Ponirakis G, Ferdousi M, Asghar O, Jeziorska M, Marshall A, Boulton AJ, Efron N, Malik RA. Vitamin D Deficiency is Associated With Painful Diabetic Neuropathy. Diabetes Metab. Res. Rev.2020 Jun 07 [Epub ahead of print]:e3361. doi: 10.1002/dmrr.3361. PMID: 32506740. Abstract.
Cite this: Vitamin D Deficiency Linked to Painful Diabetic Neuropathy - Medscape - Jun 16, 2020.