Diabetic neuropathy reduced by injection of 600,000 IU of vitamin D

Created February 2016

Vitamin D for the treatment of painful diabetic neuropathy

Emerging technologies and therapeutics

BMJ Open Diab Res Care 2016;4:e000148 doi:10.1136/bmjdrc-2015-000148

Abdul Basit1,2, Khalid Abdul Basit1, Asher Fawwad1,2, Fariha Shaheen1, Nimra Fatima1, Ioannis N Petropoulos3, Uazman Alam4, Rayaz A Malik3,4

1Baqai Institute of Diabetology and Endocrinology, Karachi, Pakistan

2Baqai Medical University, Karachi, Pakistan

3Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar

4Centre for Endocrinology and Diabetes, Institute of Human Development, University of Manchester and the Manchester Royal Infirmary, Central Manchester Hospital Foundation Trust, Manchester, UK

Professor Rayaz A Malik; rayaz.a.malik@manchester.ac.uk

Pain reduction from injection lasted about 3 months Ongoing monthly doses of oral 300,000 IU of vitamin D probably somewhat better Active vitamin D may be better still – see below See also VitaminDWiki: NEUROPATHY * Diabetic nephropathy (Kidney) treated by 50,000 IU of vitamin D weekly – RCT Jan 2019 * Pain of Diabetic Neuropathy reduced with weekly 50,000 IU vitamin D– CT Feb 2015 * Diabetic neuropathy least likely if have 30-40 ng of vitamin D – Oct 2015 * Diabetics are 2.7 X more likely to get peripheral neuropathy if low vitamin D – meta-analysis Dec 2014 * Diabetic Nephropathy – active vitamin D helps – Dec 2014 * Longstanding Diabetes ==> Kidney failure (10% of Type II, 30% of Type1) ==> Diabetic Nephropathy * Diabetic Neuropathy sometimes can be reversed by vitamin D See also VitaminDWiki: INJECTION * Diabetes (Type II) reduced by single injection of 300,000 IU of vitamin D3 – RCT March 2014 * Review of Vitamin D (including free, frequency, injection, how much.) – Sept 2013 * Vitamin D supplementation protocols: loading, injection, etc – RCT June 2014 * Reduced depression with single 300,000 IU injection of vitamin D – RCT June 2013 See also VitaminDWiki: LOADING DOSE * 300,000 IU injection loading dose of vitamin D3 stopped gestational diabetes in RCT – Oct 2011 * Overview Loading of vitamin D * 600,000 vitamin D loading doses – good response to both oral and muscular – Oct 2015 * 600000 IU dose raised youth vitamin D level by 60 ng in 3 days – July 2010 * ICU survival increased with vitamin D single 540K IU loading dose - JAMA Sept 2014 540,000 IU * Lupus flares totally eliminated by loading dose then 100000 IU of vitamin D each month – Oct 2012

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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.

Tags: Diabetes Injection Intervention Loading dose