STUDY THE EFFICACY OF CHRONIC INTERMITTENT INTRAVENOUS INSULIN INFUSION THERAPY OVER AND ABOVE CONVENTIONAL TREATMENT IN PATIENTS OF DIABETIC AUTONOMIC NEUROPATHY

Maheshwari Pk; Prabhat Agrawal; Prashant Prakash; Singh Ak; Saurabh Bansal; Deepak Purohit; Shweta Agarwal

doi:10.22159/ajpcr.2018.v11i9.25613

Authors

Maheshwari Pk Department of Medicine, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Prabhat Agrawal Department of Medicine, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Prashant Prakash Department of Medicine, Unit Head Pulmonary Medicine, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Singh Ak Department of Medicine, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Saurabh Bansal Department of Medicine, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Deepak Purohit Department of Medicine, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Shweta Agarwal Department of Pathology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i9.25613

Keywords:

Chronic intermittent intravenous insulin therapy, Diabetes mellitus, Diabetic autonomic neuropathy

Abstract

Objective: This study aims to emphasize the importance of chronic intermittent intravenous insulin infusion therapy (CIIIT) over and above conventional treatment in patients with diabetic autonomic neuropathy.

Methods: In our study, we had 50 patients; most of the patients were in the age group of 30â€“50 years and sex ratio for male:female was 3:2. The patients were divided into two groups. One group which received monthly CIIIT for 8 h per month for 6 months (Group-1) whereas other group did not receive it (Group-2). However, both groups continued their old treatment (oral hypoglycemic or subcutaneous insulin).

Results: On 12-month follow-up, in Group-1, palpitation improved in 16 of 17 (94.1%), giddiness improved in 12 of 20 (60.0%), constipation improved in 7 of 12 (58.3%), diarrhea improved in 7 of 8 (87.5%), erectile dysfunction improved in 3 of 5 (60.0%), abdominal fullness improved in 12 of 17 (70.5%), and abnormal sweating improved in 6 of 20 (30%). In comparison to this, in Group 2, palpitation improved in 6 of 19 (31.5%), giddiness improved in 2 of 15 (13.3%), constipation improved in 3 of 13 (23.0%), diarrhea improved in 3 of 7 (42.8%), erectile dysfunction improved in 3 of 5 (20.0%), abdominal fullness improved in 4 of 13 (13.7%), and abnormal sweating improved in 5 of 17 (29.4%).

Conclusion: At the conclusion of our study, we found that patients, who were previously refractory to conventional pharmacotherapy, showed a considerable response to CIIIT with most patients giving a history of improvement in their symptoms after therapy and during follow-up. Therefore, it is recommended that patients presenting with complaints of diabetic autonomic neuropathy should be managed by CIIIT rather than the conventional pharmacological therapies.

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Author Biography

Maheshwari Pk, Department of Medicine, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.

Associate Professor

P.G. Department of Medicine

References

Lakhiar MA, Shahbaz NN, Bughio AH, Prakash J. Frequency of peripheral neuropathy in newly diagnosed patients of diabetes mellitus iion clinical and electrophysiological basis. Pak J Neurol Sci (PJNS) 2014;9:31-5.

Anandvijayakumar PR, Kalshetti SM, Bhatt JK. Supplementation of Î±-lipoic acid in diabetic peripheral neuropathy: A prospective open label randomized controlled trial. Int J Pharm Pharm Sci 2014;6:90 3. Available from: https://www.innovareacademics.in/journals/index.php/ ijpps/article/view/1247/862. [Last Accessed on 2018 Apr12].

Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Complication of Diabetes Mellitus Autonomic Neuropathy in Williams Textbook of Endocrinology, 11thed. Philadelphia, PA: Saunders Elsevier; 2008. p. 1464-70.

Aoki TT, Grecu EO, Arcangeli MA, Benbarka MM, Prescott P, Ahn JH. Chronic intermittent intravenous insulin therapy: A new frontier in diabetes therapy. Diabetes Technol Ther 2001;3:102-17.

Maheshwari PK, Bansal M, Agrawal P, Agarwal A. Int J Basic Appl Med Sci 2016;6:36-40: An Open Access, International Journal. Available from: http://www.cibtech.org/jms.htm.

Aoki TT, Grecu EO, Gollapudi GM, Barber RA, Arcangeli MA, Benbarka MM, et al. Effect of intensive insulin therapy on progression of overt nephropathy in patients with Type I diabetes mellitus. Endocr Pract 1999;5:174-8.

Aoki TT, Benbarka MM, Okimura MC, Arcangeli MA, Walter RM, Wilson LD, et al. Long-term intermittent intravenous insulin therapy and Type I diabetes mellitus. Lancet 1993;342:515-8.

The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin dependent diabetes mellitus. N Engl J Med 1993;329:977-86.

Aoki, TT, Grecu EO, Arcangeli MA, Meisenheimer R. Effect of intensive insulin therapy on abnormal circadian blood pressure pattern in patients with Type 1 diabetes mellitus. Online J Curr Clin Trials 1995;199:515-8.

Daily GE, Boden GH, Creech RH, Johnson DG, Gleason RE, Kennedy FP, et al. Effects of pulsatile intravenous insulin therapy on the progression of diabetic nephropathy. Metabolism 2003;49:1491-5.

Maheshwari RA, Balaraman R, Sen AK, Seth AK. Effect of coenzyme Q10 alone and its combination with rosuvastatin on streptozotocin-nicotinamide induced diabetic neuropathy in rats. Int J Pharm Pharm Sci 2014;46:296-9. Available from: https://www.innovareacademics. in/journals/index.php/ijpps/article/view/3802/1721. [Last Accessed on 2018 Apr12].