Overview
The goal of this clinical trial is to investigate if trimetazidine can improve clinical outcomes of patients with diabetic peripheral neuropathy. The main questions it aims to answer are:
Does trimetazidine improve the symptoms of diabetic peripheral neuropathy? Does trimetazidine affect endothelin-1 levels?
Participants in the interventional arm will receive trimetazidine tablets 35 mg twice daily for three months.
Eligibility
Inclusion criteria:
- Males or females aged 18-65 years diagnosed with Type 2 Diabetes.
- Regular attendance of the outpatient diabetes clinic of national institute of diabetes to ensure adequate follow up, glycemic control and monitor any complication or side effect.
- Patients diagnosed with Diabetic Neuropathy (by pinprick, temperature, ankle reflex, and vibration perception (128-Hz tuning fork) or pressure sensation (10 g monofilament test).
- Glycated Hgb more than 7%
Exclusion criteria:
- Patients with autoimmune disorders (Sjogren's syndrome, lupus, rheumatoid arthritis), inherited disorders causing peripheral neuropathy, thyroid diseases, chronic inflammatory demyelinating polyneuropathy, patients undergoing gastroplasty surgery, and cancer patients.
- Patients have Parkinson disease or any motor movement disorders
- Any clinically significant cardiac, pulmonary, gastrointestinal, hematologic, or other endocrine disease.
- Pressure on or injury to the nerves
- Patients with kidney (eGFR less than 30 ml/min) or severe liver dysfunction (ALT more than 3x ULN).
- Patients with recent history of infection.
- Patients with cerebral vascular disease, vasculitis, toxic neuritis, spondyloarthropathy, foot edema or ulcer and diagnosis of other neuromuscular disorders or neurodegenerative diseases.
- Use of medications or supplements known to cause peripheral neuropathy.
- Patients consuming alcohol, any antioxidant supplements or anti-inflammatory medicines and drug abuse.
- Ketoacidosis or hypoglycemia resulting in hospital admission within the last 3 months.
- Pregnancy or lactation.
- Medical, psychological, behavioral or pharmacological factors interfering with the ability to participate in a trial.
- Any known allergy to Trimetazidine
