Treating Peripheral Neuropathy

People with type 2 diabetes are liable to develop peripheral neuropathy, as one of the complications of their diabetes. The effect on nerves – often those in the legs and feet – can be temporary numbness, tingling, and pricking sensations, sensitivity to touch, or muscle weakness; more extreme symptoms include burning pain, especially at night.

A new study, presented at the recent American Diabetes Association Meeting, describes the effects of treatment with statins and fibrates before the neuropathy developed. Almost 1,300 patients with type 2 diabetes were enrolled and followed for up to 8 years. In the first 3 years of the study, 6.6% of the patients were prescribed statin therapy and 3.5% were prescribed a fibrate (typically gemfibrazol). The use of fibrates was associated with a 70% reduction in the prevalence of neuropathy symptoms, while statin therapy had no apparent effect.

However, during the next 5 years, the use of fibrates and statins increased to 10% and 37%, respectively. At that time 26% of the patients already had neuropathy. During the next 5 years, 62% of the patients developed new neuropathy. However, it was shown that fibrates and statins cut the risk of neuropathy symptoms by 48% and 35%, respectively.

One cannot give too much importance to this finding, as this was not a prospective randomized double-blind study. However, it may be assumed that the reported beneficial effects are related to their effects on lipids. But it should also be noted that both also have anti-inflammatory effects, albeit not as strong as true anti-inflammatory agents like ibuprofen (Advil®).