[ comparsion of nortriptiline and vit B12 effects on diabetic neuropathy]

ABSTRACT

Diabetes is one of the most prevalent disease in the world.Today there are 100 milion diabetics around the world and in Iran it is about 1.5 milion. The prevalence of symptomatic neuropathy is 15% but with NCV it will increase to 50%. Regarding the suffer produced by neuropathy and that there is no effective treatment for that, this is necessary to investigate new treatment options. This is a clinical trial study, done during a 3 months period in vali-e-asr hospital in year 2004. 100 diabetic patients were selected randomly and divided into two equal groups. A complete sensorimotor assessment was performed and a questionnaire consisting history and clinical symptoms including limb pain, murmur and paresthesia and examinations such as pin prink test, position and vibration assessment, was completed. NCV was also done and blood sugar and HbAlc was measured. In case group 2000 micrograms vit B12 was prescribed twice weekly and in control group 10mg nortiptiline every night was prescribed. After 3 months patients were assessed again. Data was analysed using mean and standard deviation and Chi square, K-S, Leven, T and Mann Whitney tests. Based on visual analage scale the difference between pain number before and after treatment was decreased 3.66 [3.66-4.25] in case and 0.48 [0.54-1.13] in control group [P< 0.0001]. Also the difference between paresthesia number before and after treatment was decreased 2.98 [2.51-3.44] in case and 1.06 [064-1.47] in control group [P< 0.001]. The differene between murmur number before and after treatment was decreased 3.48 [2.93-4.02] in case and 3.48 [2.93-4.02] in control group [P< 0.001]. There was no significant difference between NCV, vibration, position and pin prink test results. Changes in clinical symptoms in case group in comparison to those in control group was significant, but change in physical assessment findings [pin prink, Position, vibration and NCV] was not significant