A  recent study has reported lack of sufficient Vitamin D to be associated with increased risk for painful  diabetic neuropathy. Researchers have published their findings in Diabetes/Metabolism  Research and Reviews.
The aetiology of painful diabetic neuropathy is unclear. The researchers evaluated vitamin D levels in diabetic patients with and without painful neuropathy. Previous studies have shown a significant  association between vitamin D deficiency and the development of diabetic  peripheral neuropathy (DPNDPN), particularly in Asian patients. Possible   association between vitamin D deficiency and  painful diabetic neuropathy has also been reported.
    The aim of the present study was to evaluate  the levels of vitamin D in patients with painful as compared with painless  diabetic neuropathy .
    The researchers included a study sample of forty‐three patients with type 1 diabetes divided into  two groups of painless neuropathy (DPN) (n = 20) and painful neuropathy (PDN)  (n = 23).They were compared with a control group which consisted of  non‐diabetic healthy control(C) subjects (age, sex and ethnicity  matched).
    The sample population went through a complete assessment  of neurologic deficits, quantitative sensory testing (QST), electrophysiology,  skin biopsy, corneal confocal microscopy (CCM) and measurement of serum 25(OH)  D.Values below 20 ng/mL and 30 ng/mL was regarded  as Vitamin D deficiency and insufficiency  respectively.
    Results revealed that serum 25(OH) D levels  were significantly lower in PDN (24.0 ± 14.1 ng/mL) compared with DPN  (34.6 ± 15.0 ng/mL, P = .01) and controls (34.1 ± 8.6  ng/mL, P = .03). There was a 10-fold increased risk for painful diabetic  neuropathy (odds ratio [OR], 9.8; 95% CI, 2.2-76.4; P=.003) in  Vitamin D deficient patients (<20 ng/mL). It was also noted that  Vitamin D deficiency (<20 ng/mL) was  associated with more than a 4-fold increased risk to PDN (OR, 4.4; 95 CI,  1.1-19.8; P=.03).
    According to the authors, the major strength of this study was a fully  matched and detailed phenotyping of the diabetic patients with and without  painful neuropathy .Certain  limitations  like  the small sample size, lack of  quantification of sunlight exposure or daily activity and comparison with a non‐neuropathic diabetic cohort were also  acknowledged.
    The researchers further quoted that a well‐constructed clinical trial of vitamin D in  painful diabetic neuropathy is required to assess the effectiveness of a  potentially simple treatment with no obvious side effects.
     
    Source  Reference  :https://doi.org/10.1002/dmrr.3361
   					  				
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