Novel and Emerging Therapies
Stem cells have emerged as an intriguing treatment for diabetic neuropathy on multiple fronts. One possible use for stem cells is treating the elevated glucose levels that cause diabetic neuropathy. Research suggests that stem cell transplantation can protect and restore the insulin-secreting cells of the pancreas, lowering blood glucose levels and relieving diabetic neuropathy and other complications (Sino Stem Cells 2013; GSCN 2013). Stem cells may also improve blood flow to damaged nerves, helping reduce pain and heal neurons crippled by diabetic neuropathy (Kim 2012). In addition, researchers found that certain stem cells, termed mesenchymal stem cells, may be able to reduce inflammation and thus relieve diabetic neuropathy pain (Waterman 2012). Stem cells continue to be developed and may become more widely available in the not-too-distant future.
Nabilone (Cesamet®) is a synthetic cannabinoid, which means it has some of the same properties as constituents of marijuana. It is sometimes used to treat nausea due to chemotherapy but may also be effective in treating pain caused by diabetic neuropathy (Toth 2012). Two different studies found that nabilone is effective at relieving diabetic neuropathic pain and also improved the mood and overall quality of life for diabetics. These studies also found that treatment with nabilone improved sleep in patients suffering from diabetic neuropathy (Toth 2012; Bestard 2011). This is important because for many, the pain of diabetic neuropathy is worse at night (Ziegler 2009). Physicians may prescribe nabilone as an off-label treatment option for painful neuropathy.
Botulinum toxin, a neurotoxin secreted by the bacterium Clostridium botulinum, blocks signaling from the neurotransmitter acetylcholine. Botulinum toxin can be injected in small quantities to temporarily disable nerves and muscles; it is often used for cosmetic reasons or to treat muscle spasticity (Jabbari 2011; Bach-Rojecky 2010). Early studies suggest that injection of botulinum toxin to sites of painful diabetic neuropathy may significantly reduce pain and improve sleep quality, though more studies are needed to determine the effectiveness of this treatment (Yuan 2009; Francisco 2012).