Effectiveness of Metanx Prescription Medical Food on Small Nerve Fibers and Monofilament Sensation in Patients with Diabetic Peripheral PolyneuropathyReportar como inadecuado




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Purpose: Diabetic peripheral neuropathy DPN is prevalent among thepopulation with type 2 diabetes, and treatment approaches are limited. Thecombination of L-methylfolate-methylcobalamin-pyridoxal-5-phospate LMF-MC-PP,Metanx? is a prescription medical food that has demonstratedsignificant improvements in sensory perception and quality of life as well as reducedneuropathic pain in patients with DPN. The present study examined the effectsof LMF-MC-PP on sensory perception and epidermal nerve fiber density ENFDamong patients with confirmed DPN. Methods: Patients with type 2 diabetes anddiagnosed with diabetic peripheral polyneuropathy, based on loss of vibratoryperception, warm-cold discrimination or monofilament sensation, underwentbilateral lower extremity ENFD assessments via skin punch biopsy and werestarted on LMF-MC-PP. ENFD and monofilament testing were repeated at 6 months. Findings:Of 123 patients evaluated, all had monofilament testing at baseline and 6months and 122 had assessments at both time points. A significant p < 0.05 improvement in ENFD from baseline to 6months was observed. A significant p = 0.0001 improvement in monofilament testing also was observed. Overall, more patients had intact sensationafter 6 months, with 60 48.8% of 123 patients having positive monofilamenttest at baseline as compared to 95 77.2% positive after 6 months. An analysisof the association between improvements in ENFD and monofilament testing foundthat the two tended to occur together, and this was significant p < 0.05 forthe right limb. Implications: Clinically important and statisticallysignificant improvements in ENFD and monofilament sensation were associatedwith LMF-MC-PP in patients with DPN. When compared to the decrease in ENFD expectedamong DPN patients, the improvements are even more clinically significant.These findings should be validated in a larger, placebo-controlled study.

KEYWORDS

Diabetic Neuropathy, Epidermal Nerve Fiber Density, LMF-MC-PP, Monofilament Testing, Small Nerve Fibers

Cite this paper

McNamara, V. , Vinik, A. , Barrentine, L. and De Vol, E. 2016 Effectiveness of Metanx Prescription Medical Food on Small Nerve Fibers and Monofilament Sensation in Patients with Diabetic Peripheral Polyneuropathy. Journal of Diabetes Mellitus, 6, 166-174. doi: 10.4236-jdm.2016.62018.





Autor: Victor F. McNamara1, Aaron I. Vinik2, Lori Barrentine3, Edward B. De Vol4

Fuente: http://www.scirp.org/



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