More than half of all patients with diabetes develop neuropathy. Their nerves slowly deteriorate. Researchers are testing antioxidants to see if the vitamin-like compounds can nurse sick nerves back to health.
Catherine Driessche was a teenager when painful neuropathy started in her feet and legs.
“I even had it in my groin," she says. "When it gets really bad and it’s, like makes me wanna’ cry ‘cause it hurts so bad.”
The future nurse has type one diabetes. There's too much sugar in her body and it’s destroying her nerves.
“I hope that it doesn’t get any worse,” she says.
It won’t if University of Michigan researcher Eva Feldman has her way. She’s conducting a study to see if concentrated doses of antioxidants can stop nerve damage.
Dr. Feldman says, "We’ve learned that in type 1 diabetes and patients affected with this particular complication, neuropathy, there’s evidence of increased oxidative stress.”
Oxidative stress is the breakdown of cells by free radicals.
Dr. Feldman says, "We hopefully are learning if we target drugs mechanistically to block that oxidative stress we may be able to either ameliorate neuropathy or stop its progression."
In patients with type one diabetes, nerve damage can go on for years before symptoms show up.
Dr. Feldman says, "In those patients sometimes when their feet become troublesome they actually at the same time have trouble with the nerves that go to the heart. You don’t see that as much with patients with type 2 diabetes.”
If the antioxidant cocktail works, it would be the first effective treatment for diabetic neuropathy.
Antioxidants used in the study include alpha lipoic acid, nicotinamide and allopurinol.
Type one patients interested in the study can call the University of Michigan study coordinator at 734-936-8065.
Supplemental Information
Fast Facts:
Approximately 18.2 million Americans have diabetes.
Type 1, the less common form of the condition, accounts for 5 to 10 percent of all cases.
Over time, more than half of all patients with diabetes will develop signs of neuropathy, or nerve damage.
Antioxidant supplements may reduce or stop the cellular damage associated with high glucose levels and lower the risk of diabetic neuropathy.
For more details, refer to our comprehensive research summary.
Type 1 Diabetes
Type 1 diabetes is a condition in which the pancreas doesn’t produce insulin, a hormone needed to convert glucose (a type of sugar) into energy. Despite eating an adequate amount of food and having high levels of glucose in the blood, the body is unable to get the fuel into the cells. Patients need regular injections of insulin to stay alive.
According to the American Diabetes Association, about 18.2 million Americans have diabetes. Type 1 is less common than the other form, type 2 (type 1 accounts for only about 5 to 10 percent of all cases of diabetes). Although type 1 diabetes can occur at any age, it’s most commonly diagnosed in children and young adults.
Complications of Diabetes: Neuropathy
Over time, about half of patients with diabetes develop signs of neuropathy, or nerve damage. There are four main types of neuropathy.
Peripheral neuropathy affects the nerves in the legs, feet, hands and arms. It can cause tingling, pain, numbness and weakness in the affected area. Patients may lose the ability to feel an injury, causing a wound that doesn’t heal. The feet are especially at risk. Diabetes is a common cause of amputations in the U.S. Researchers estimate people with diabetes and neuropathy have a 15 percent chance of requiring one or more amputations in their lifetimes.
Autonomic neuropathy affects the nerves that control “automatic functions.” Damage to these nerves can cause problems with digestion, bowel and bladder function, sexual function, perspiration, vision and the cardiovascular system. Patients with autonomic neuropathy may also have a hard time detecting the body’s warning signs of low blood sugar.
Proximal neuropathy causes pain in the thighs, hips, buttocks or legs. The legs may also become weak, causing problems moving from a sitting to a standing position.
Focal neuropathy is a condition that affects a specific group of nerves. It can affect any nerve group, but is most commonly seen in the head, torso or leg. Patients may report vision problems (such as the inability to focus), one-sided facial paralysis, lower back or hip pain, thigh pain and chest or stomach pain.
Antioxidants for Diabetic Neuropathy
The cells of the body use oxygen when they produce energy. That process produces toxic byproducts, called free radicals, which can damage DNA and proteins. This is called oxidative stress.
Normally, the body produces natural antioxidants to take up the free radicals to prevent or reduce damage to the cells. We can also get some antioxidants in our diet (like from foods rich in vitamin C, vitamin E and beta carotene). But if there are too many free radicals or too few antioxidants, the cells of the body can be damaged by oxidative stress.
Researchers theorize that in diabetics, high levels of glucose in the blood disrupt cellular metabolism and cause an overproduction of free radicals and oxidative stress. That process may lead to the development of diabetic neuropathy.
At the University of Michigan Health System, investigators are studying the use of antioxidant supplements in people with type 1 diabetes.
Doctors want to find out if the treatment will block oxidative stress and reduce the risk or stop the progression of neuropathy. The researchers are currently looking at three different antioxidants: alpha-lipoic, nicotinamide (vitamin B3) and allopurinol. Studies in animals suggest the supplements may be helpful in increasing the levels of antioxidants in the body. Hopefully, the current study will also prove the treatments to be useful for humans as well. Type 1 patients from around the country who are interested in participating in the study can call the University of Michigan study coordinator at 734-936-8065.
Web Resources
For information about the research and other projects regarding diabetic neuropathy at the University of Michigan, visit their Web site
Type one patients who are interested in participating in the study can call the study coordinator at 734-936-8065.
For information about diabetes or diabetic neuropathy:
American Diabetes Association Web site
Juvenile Diabetes Research Foundation International Web site
National Institute of Diabetes and Digestive and Kidney Disease Web site
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