Vitamin E for Diabetic Peripheral Neuropathy: Does It Help?
Supplementation with oral mixed tocotrienols is not associated with improved overall neuropathic symptoms among individuals with diabetic peripheral neuropathy, a new study found.
For the Vitamin E in Neuroprotection Study (VENUS), the researchers screened 14,289 Malaysian patients with diabetes and further assessed 391 eligible patients who reported neuropathic symptoms. Eligiblility was determined using the Total Symptom Score (TSS) and Neuropathy Impairment Score (NIS).
Eligible patients were randomly assigned to receive either twice-daily 200 mg mixed tocotrienols or matching placebo for a period of 12 months. Additionally, patients in both groups who had hyperhomocysteinemia were treated with once-daily 5 mg oral folic acid and three-times-daily 500 μg methylcobalamin.
Ultimately, 300 patients were recruited and 229 completed the trial. Results demonstrated that similar changes in TSS occurred in both groups at 12 months (-0.30), and that no significant between-group differences were observed in regard to NIS and sensory nerve conduction test assessments.
According to post hoc subgroup analyses, tocotrienols were also found to reduce lancinating pain in patients with hemoglobin A1c levels of more than 8% and normohomocysteinemia at 1 year.
The researchers noted that the occurrence of serious adverse events was similar in both groups, although more infections occurred in those treated with tocotrienols (6.7% vs 0.7%).
“Supplementation of oral mixed tocotrienols, 400 mg/d for 1 year, did not improve overall neuropathic symptoms,” the researchers concluded. “The preliminary observations on lancinating pain among subsets of patients require further exploration.”
—Christina Vogt
Reference:
The Vitamin E in Neuroprotection Study (VENUS) Investigators. Efficacy of oral mixed tocotrienols in diabetic peripheral neuropathy: a randomized clinical trial [Published online January 29, 2018]. JAMA Neurol. doi:10.1001/jamaneurol.2017.4609.