Is the C677T polymorphism in methylenetetrahydrofolate reductase gene or plasma homocysteine a risk factor for diabetic peripheral neuropathy in Chinese individuals?

The present study enrolled 251 diabetic patients, including 101 with neuropathy and 150 without neuropathy. Of the 150 patients, 100 had no complications, such as retinopathy, nephropathy, or neuropathy. Polymerase chain reaction-restriction fragment length polymorphism analysis was used to identify methylenetetrahydrofolate reductase gene variants. Plasma homocysteine levels were also measured. Homocysteine levels and the frequency of hyperhomocysteinemia were significantly higher in patients with diabetic peripheral neuropathy compared with diabetic patients without neuropathy （P 〈 0.05）. In logistic regression analysis with neuropathy as the dependent variable, the frequency of C677T in methylenetetrahydrofolate reductase was significantly higher in patients with diabetic peripheral neuropathy compared with patients without diabetic complications. Homocysteine levels were significantly higher in patients with diabetic peripheral neuropathy carrying the 677T allele and low folic acid levels. In conclusion, hyperhomocysteinemia is an independent risk factor for diabetic neuropathy in Chinese patients with diabetes. The C677T polymorphism in methylenetetrahydrofolate reductase and low folic acid levels may be risk factors for diabetic peripheral neuropathy in Chinese patients with diabetes.

meta-analysis of randomized controlled trials of combined treatment with DGSN and western medicine on diabetic peripheral neuropathy

Objective:To systematically study the clinical effects of combined treatment with Dang gui si ni tang(DGSN)and western medicine(WM)on diabetic peripheral neuropathy.Methods:Seven databases,including Chinese National Knowledge Infrastructure(CNKI),Chinese Biomedical Database(CBM),Wanfang full-text database,VIP Database for Chinese Technical Periodicals,MEDLINE,PubMed,Embase,were retrieved.Related references about randomized controlled trials on the combination of DGSN and WM on diabetic peripheral neuropathy published during January 2012 up to now(recent 5 years)were reviewed.Related grey literatures were also reviewed according to the selected articles.RevMan5.3 software was used to analyze the publish bias,and to compare the total clinical effects of the combination of DGSN and WM with WM alone.Results:Ultimately,19 randomized controlled trials with 1690 patients were incorporated.The results of meta-analysis showed that combined treatment of diabetic peripheral neuropathy with DGSN and WM showed better general efficacy compared with control group,with a statistically significant difference(P<0.05).The results of study showed homogeneity(P=0.94>0.05).The general efficacy of combined treatment with DGSN and WM was significantly higher than that of control group(P<0.00001,OR=3.98,95%CI:3.01~5.27).Conclusion:Compared with treatment with WM alone,combined treatment of diabetic peripheral neuropathy with DGSN and WM is more effective.Meanwhile,due to the limited literature samples and low quality of literatures,large samples and high quality of multi-center randomized controlled double-blind trials are needed to verify these results.

Clinical observation on TCM fumigation and washing for treatment of diabetic peripheral neuropathy by self-made water-washing footbath

the quality of life seriously,and even lead to more servere complications.On the base of the well-controlled blood glucose,improving the symptoms of both lower limbs timely will has positive significance for enhancing the life quality of patients and preventing complications of limbs.This article makes a comprehensive study on the application of self-made water-washing footbath in the treatment of DPN by Chinese medicine fumigation.From March 2018 to April 2018 in our hospital 20 cases of DPN patients were collected and they were divided into observation group(treated by self-made water-washing footbath with herbs)and control group(treated by conventional barrels),10 cases in each.The results showed that Chinese medicine fumigation on both lower limbs has clinical curative effect to improve the symptoms of arthromyodynia caused by diabetes.It provide an alternative method of external treatment for DPN patients with numbness in both lower limbs which could alleviate their suffering and improve the quality of life significantly.