Nitroglycerine Spray For Diabetic Neuropathy
Glyceryl-Trinitrate Spray Effective for Painful Diabetic Neuropathy
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By C. Vidyashankar, MD
CHENNAI, India (Reuters Health) Jun 29 - While it's normally used as a vasodilator in angina pectoris, glyceryl-trinitrate produces a significant improvement in pain associated with diabetic neuropathy, researchers from India report.
In a double-blind, placebo-controlled crossover trial, Dr. R.P. Agrawal and colleagues from the S. P. Medical College, Bikaner in western India, evaluated the efficacy of topical glyceryl-trinitrate spray in 48 patients with painful diabetic neuropathy.
Twenty-four patients in the study group used glyceryl-trinitrate spray topically on their legs at bedtime for four weeks, while the other 24 used a placebo spray. After a wash-out period of 2 weeks, the participants switched to the opposite arm for a further for 4 weeks. The severity of pain was assessed using the McGill pain questionnaire, visual analogue score, present pain intensity score and 11-point Lickert scale.
On completion of the trial, all the pain scores were significantly lower while the patients were receiving glyceryl-trinitrate spray rather than the placebo, Dr. Agrawal and colleagues report in the August 2006 issue of Diabetes Research and Clinical Practice.
The analgesic effects persisted till the next application and improved sleep satisfaction, the researchers add.
Glyceryl-trinitrate was well tolerated and only one patient was withdrawn from the study because of adverse effects.
Vasodilation due to nitric oxide, a derivative of glyceryl-trinitrate, may explain its analgesic effects, while stimulation of angiogenesis in the blood vessels supplying the nerves could explain the temporal increase in the analgesic effects with continued usage, Dr. Agrawal's team suggests.