Diabetic Neuropathy

Approach 

The most common type of neuropathy is distal symmetrical polyneuropathy, which involves loss of vibration in the toes and loss of ankle reflexes. This can be found on a routine physical exam. Symptoms include numbness and paresthesias that may cause severe burning and prickling sensations. Pathological examination shows axonal destruction due to the complications of sorbitol buildup. Mononeuropathies come on with a sudden onset and leave usually spontaneously. They may affect the third, fourth, sixth, and seventh cranial nerve. Truncal neuropathy in the T4 -T12 area also exists. The pain is constant, unrelenting, worse at night, and is often confused with cardiac or gastrointestinal disease.
     Many drugs inhibit the absorption of vitamin B-12 and can cause vitamin deficiency-induced neuropathy that must be differentiated from hyperglycemia-induced neuropathy. Neuropathy and vascular disease account for the high incidence of diabetic foot amputations. Diabetic neuropathic cachexia involves neuropathy along with symptoms of anorexia and depression. Autonomic neuropathy, including both sympathetic and parasympathetic nerves, can cause a variety of problems, including resting tachycardia, postural hypotension, bladder dysfunction, and lack of peristalsis in the stomach (gastroparesis).

Clinical Nutrition 

Pyridoxine and Vitamin B-12: High doses of pyridoxine (100 mg) and vitamin B-12 (1000 mcg) can improve nerve function.

Vitamin E and Alpha-lipoic acid: Vitamin E at doses of 800 IU or higher, along with lipoic acid (300 mg), will inhibit protein glycosylation.

Quercitin: Quercitin at 2 g daily will inhibit the polyol pathway and give great benefit.

Botanical Medicine 

St. John’s wort: Clinically, we have found that one teaspoon of St. John's wort tincture, three times a day, relieves neuropathy and prevents progression of the neuropathy. St. John’s wort is a nervine herb that can strengthen the health of the nerves. Patients usually respond within a week to this protocol.

Essential Oil of Geranium: This oil has also proven to be effective in decreasing neuropathy pain.

Conventional Allopathic Treatment 

Allopathic medicine has no effective treatment for diabetic neuropathy. Steroids and antidepressants have been tried with poor results.

Diabetic Nephropathy 

Approach 

End-stage renal disease, cardiovascular disease, and mortality are great risk for patients suffering from diabetic nephropathy. Nephropathy leads to systemic hypertension because of hyperlipidemia and a decreased clearance of atherogenic advanced glycosylation end products.

Diabetic Complications
There are five aspects that need to be considered in therapy for diabetic complications.

•  Hyperglycemia needs to be controlled as well as possible.
•  Free radical production in hyperglycemia needs to be quenched.
•  The polyol pathway in which excess sugar alcohols are produced needs to be inhibited.
•  The organs that are affected, such as the eyes, kidneys, and nerves, need to be supported.
•  Protein glycosylation needs to be inhibited.

Inihibiting Polyol Pathway and Free Radical Formation

•  Quercitin: 2 g daily
•  Vitamin C: 2 g daily
•  IV Gluatahione: 100 mg daily
•  Grape seed extract: 100 mg daily

Inhibiting Protein Glycosylation and Decreasing Polyol Formation

•  Lipoic Acid: 200-500 mg daily
•  Quercitin: 1-2 g daily
•  Vitamin E: 400-12000 IU daily