If we’re lucky, we will get diabetic neuropathy in our lifetimes. Nearly 60 percent of people with diabetes in America have it after a quarter of a century.
Neuropathy may be the most common complication of diabetes and can make walking difficult as well as leading to even more serious problems like losing a limb. Diabetic neuropathy is damage caused to the nerves, and it can result in numbness, tingling, burning, and pain. Until now the painkillers that we could use don’t work well for everyone.
Now, however, a study from the University of Calgary shows evidence supporting a new drug therapy to treat diabetic neuropathy. The drug is called nabilone.
"My pain was so severe that I could barely walk a block," says Leslie Bonenfant, who has type 2 diabetes and participated in the study. "After taking nabilone, I can manage my pain and I can function day to day," she says.
Leslie Bonenfant (left) during a medical exam with Dr. Cory Toth
The U.S. and Canadian governments have already approved nabilone. The approval is for another condition, but doctors can prescribe drugs approved for one condition to treat other conditions. We call this off-label use.
The researchers treated 60 people with diabetic neuropathy in a 12-week placebo-controlled clinical study. Compared with those people in the placebo group, the people who got nabilone said they had less pain and anxiety. They also slept better.
The study appears in the October issue of the journal Pain. Only the abstract is online, but Dr. Cory Toth, the lead author, kindly sent me the full-text. Dr. Toth is assistant professor in the university’s department of clinical neurosciences and the director of the Neuropathic Pain Clinic.
"Nabilone is a good option to help treat nerve pain due to diabetes with very few side effects," Dr. Toth says. The people in the study who took nabilone tolerated it well.
"Virtually all diabetics who have experienced ongoing higher-than-normal blood sugars for more than five years suffer some loss of sensitivity in their feet to pain, pressure, and temperature, Dr. Richard K. Bernstein writes in Dr. Bernstein’s Diabetes Solution. "This is because prolonged blood sugar elevation can injure and eventually destroy all sensory nerves in the feet (sensory neuropathy)."
He says that we may be able to reverse this sensory neuropathy with tight blood sugar control. But at best this takes a lot of time.
Meanwhile, pain relief is crucial if we live long enough with high blood sugar to get neuropathy. But we would be even more lucky when we avoid getting neuropathy in the first place by making sure that our blood sugar level is normal.
David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.