Chronic diabetic painful neuropathy &cardiovascular risk factors in NIDDM

University Of Michigan At Ann Arbor, Ann Arbor MI

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Abstract

There are currently 7 million Americans with non-insulin dependent (type II) diabetes. The prevalence of coronary heart disease (CHD) in type II diabetes is currently at least 20% in subjects 65 years and older. Numerous studies indicate peripheral vascular disease as a common complication in patients with diabetes. Diabetic Painful Neuropathy (DPN) affects 5-50% of patients with type II diabetes and is aggravated by poor blood sugar control. Symptoms of DPN include tingling and burning sensations in the calves, ankles and feet. Conventional treatment for DPN include antidepressants and anti-convulsants, which have low effectiveness. The American Diabetes Association (ADA) recommends the diet and exercise in type II diabetes as the primary means of blood sugar control, and for the prevention and management of DPN. Because of the increased levels of leg and foot pain, patients with DPN are less likely to include exercise as a part of their health regimen. Cardiac diabetic autonomic neuropathy (DAN) commonly complicates patients with diabetes, is usually found in association with DPN, and has been invoked as a cause of sudden death in diabetic patients. Currently, a successful means of therapy for patients with DAN has not been identified. A therapeutic modality known as Reiki is a bio-energy manipulation technique similar to Therapeutic Touch (TT), a method familiar in nursing for the relief of chronic pain, and has been suggested to significantly increase some blood constituents in hospitalized patients, and to accelerate healing in full thickness skin wounds. The experimental approach is to apply Reiki to patients with DPN +/- DAN in a semi-double blind, randomized, three period study. The three groups will consist of the application of Reiki, a placebo technique and a standard care control group. All measures of efficacy will be collected at baseline and within two weeks after the end of treatment. These will include glycosylated hemoglobin values, and a lipid profile. Quality of Life (QOL) and Pain assessment questionnaires will be administered. Participants will also be tested as to their ability to perform a standardized 6 minute walk test and standardized cardiovascular autonomic reflex testing will be performed at baseline, after each treatment set, and the end of the study. This study will help determine whether an alternative therapy can reduce pain perception in patients with type II diabetes, increase their levels of exercise, improve blood sugar control and decrease other cardiovascular risk factors including DAN.