Case Series: Reversal of Diabetic Neuropathy Utilizing Physiologic Insulin Resensitization

Skin Breakdown ◽

Diabetes is a growing global problem that is currently on the rise. Type 2 diabetes (T2D) is a chronic condition that results from aberrant B-cell function coupled with progressive insulin resistance. The majority of Type 2 diabetic patients develop diabetic neuropathy, which can lead to devastating complications (i.e., infection, ulceration, osteomyelitis, & amputation). The proinflammatory state of diabetes, along with prolonged hyperglycemia damages peripheral nerves (most common in the lower extremities). Additionally, compromised wound healing exacerbates the risk when skin breakdown occurs in this patient population. To overcome these risks for T2D, physiologic insulin resensitization (PIR) has been used as a novel protocol to treat patients with severe neuropathy symptoms. In our case study, we present two patients who initially experienced a loss of sensation in their extremities and decreased wound healing. Using PIR treatment, we demonstrate that both patients experienced neuropathy reversal and improved wound healing.

Improved <i>β</i>-cell function rather than increased insulin sensitivity is associated with reduction in hemoglobin A1c in newly diagnosed Type 2 diabetic patients treated with metformin

Journal of Diabetes Mellitus ◽

10.4236/jdm.2014.41008 ◽

2014 ◽

Vol 04 (01) ◽

pp. 44-49

Author(s):

Satoru Sumitani ◽

Shinya Morita ◽

Reiko Deguchi ◽

Koichi Hirai ◽

Kosuke Mukai ◽

...

Keyword(s):

Insulin Sensitivity ◽

Hemoglobin A1c ◽

Cell Function ◽

Diabetic Patients ◽

Newly Diagnosed ◽

Effect of Glycemic Control on Electrophysiologic Changes of Diabetic Neuropathy in Type 2 Diabetic Patients

The Kaohsiung Journal of Medical Sciences ◽

10.1016/s1607-551x(09)70271-2 ◽

2005 ◽

Vol 21 (1) ◽

pp. 15-21 ◽

Cited By ~ 7

Author(s):

Chun-Chiang Huang ◽

Chia-Ling Lee ◽

Mao-Hsiung Huang ◽

Tien-Wen Chen ◽

Ming-Cheng Weng ◽

...

Keyword(s):

Glycemic Control ◽

Diabetic Neuropathy ◽

Diabetic Patients ◽

Resveratrol improves insulin sensitivity, reduces oxidative stress and activates the Akt pathway in type 2 diabetic patients

British Journal Of Nutrition ◽

10.1017/s0007114511000316 ◽

2011 ◽

Vol 106 (3) ◽

pp. 383-389 ◽

Cited By ~ 374

Author(s):

Pál Brasnyó ◽

Gergő A. Molnár ◽

Márton Mohás ◽

Lajos Markó ◽

Boglárka Laczy ◽

...

Keyword(s):

Oxidative Stress ◽

Insulin Resistance ◽

Insulin Sensitivity ◽

Cell Function ◽

Diabetic Patients ◽

Β Cell ◽

Β Cell Function ◽

Although resveratrol has widely been studied for its potential health benefits, little is known about its metabolic effects in humans. Our aims were to determine whether the polyphenol resveratrol improves insulin sensitivity in type 2 diabetic patients and to gain some insight into the mechanism of its action. After an initial general examination (including blood chemistry), nineteen patients enrolled in the 4-week-long double-blind study were randomly assigned into two groups: a resveratrol group receiving oral 2 × 5 mg resveratrol and a control group receiving placebo. Before and after the second and fourth weeks of the trial, insulin resistance/sensitivity, creatinine-normalised ortho-tyrosine level in urine samples (as a measure of oxidative stress), incretin levels and phosphorylated protein kinase B (pAkt):protein kinase B (Akt) ratio in platelets were assessed and statistically analysed. After the fourth week, resveratrol significantly decreased insulin resistance (homeostasis model of assessment for insulin resistance) and urinary ortho-tyrosine excretion, while it increased the pAkt:Akt ratio in platelets. On the other hand, it had no effect on parameters that relate to β-cell function (i.e. homeostasis model of assessment of β-cell function). The present study shows for the first time that resveratrol improves insulin sensitivity in humans, which might be due to a resveratrol-induced decrease in oxidative stress that leads to a more efficient insulin signalling via the Akt pathway.

A rapid increase in beta-cell function by multiple insulin injections in type 2 diabetic patients is not further enhanced by prolonging treatment

Journal of Internal Medicine ◽

10.1046/j.1365-2796.2002.00956.x ◽

2002 ◽

Vol 251 (4) ◽

pp. 307-316 ◽

Cited By ~ 18

Author(s):

L. KARVESTEDT ◽

G. ANDERSSON ◽

S. EFENDIC ◽

V. GRILL

Keyword(s):

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Diabetic Patients ◽

Current Status of Diabetic Peripheral Neuropathy in Korea: Report of a Hospital-Based Study of Type 2 Diabetic Patients in Korea by the Diabetic Neuropathy Study Group of the Korean Diabetes Association

Diabetes & Metabolism Journal ◽

10.4093/dmj.2014.38.1.25 ◽

2014 ◽

Vol 38 (1) ◽

pp. 25 ◽

Cited By ~ 19

Author(s):

Jong Chul Won ◽

Sang Soo Kim ◽

Kyung Soo Ko ◽

Bong-Yun Cha

Keyword(s):

Peripheral Neuropathy ◽

Diabetic Neuropathy ◽

Diabetic Peripheral Neuropathy ◽

Current Status ◽

Diabetic Patients ◽

Study Group ◽

Analysis of the Associations between Vitamin D and Albuminuria orβ-Cell Function in Chinese Type 2 Diabetes

BioMed Research International ◽

10.1155/2014/640909 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Xiaoling Cai ◽

Zhaoheng Hu ◽

Ling Chen ◽

Xueyao Han ◽

Linong Ji

Keyword(s):

Insulin Resistance ◽

Vitamin D ◽

Cell Function ◽

Diabetic Patients ◽

Albumin Creatinine Ratio ◽

Urine Albumin ◽

Vitamin D Supplement ◽

Objective. To investigate the associations of 25-(OH)D andβ-cell function or insulin resistance or albuminuria in Chinese type 2 diabetic patients.Methods. In total, 1408 type 2 diabetic patients without vitamin D supplement were included in this retrospective study.Results. Comparison between patients with and without 25-(OH)D deficiency indicated that, compared with patients with 25-(OH)D ≥ 50 nmol/L, patients with 25-(OH)D < 50 nmol/L showed a higher level of urine albumin-creatinine ratio (ACR) (90.15±10.30 mg/g versus52.79±14.97 mg/g). Multiple regression analysis indicated that 25-(OH)D was independently and negatively correlated with urine ACR (OR=0.985, 95%CI 0.972–0.999,P=0.03), adjusted by age, diabetic duration, HBP duration, SBP, HbA1c, creatinine, LDL-C, triglyceride, total cholesterol, and HDL-C. Compared with patients with normal level of urine ACR, patients with higher level of urine ACR showed a significant lower level of 25-(OH)D (34.49±13.52 nmol/L versus37.46±13.6 nmol/L,P=0.00). Analysis of the associations of 25-(OH)D andβ-cell function or insulin resistance showed that 25-(OH)D may not correlate withβ-cell function or insulin resistance.Conclusion. 25-(OH)D was independently associated with albuminuria in Chinese type 2 diabetic patients but was not associated withβ-cell function or insulin resistance.