title: Effect of intravenous versus subcutaneous insulin delivery on the intensity of neuropathic pain in diabetic subjects.
abstract: BACKGROUND
  The effectiveness of treatment of painful diabetic polyneuropathy remains unsatisfactory. The aim of this study was to compare effects of intravenous vs. subcutaneous insulin delivery in patients with diabetic symmetric sensorimotor polyneuropathy on pain relief, the quality of life, sleep disturbance, and the nerve conduction.
  
  
  METHODS
  Thirty-four patients with diabetic polyneuropathy (mean age 62 ± 10 years, duration 17 ± 10 years), who reached a pain score over 40 mm on the VAS scale, HbA(1c) 7.5-10%, were randomly assigned to continuous intravenous insulin infusion (examined group) and multiple injections (control subjects). Before and after five days of the insulin treatment the effects on pain relief (SFMPQ-VAS), the quality of life improvement (EuroQol EQ-5D), and sleep disturbances (AIS) were assessed.
  
  
  RESULTS
  Both groups experienced significant pain reduction, improvement of the quality of life, and reduction of sleep disturbances, i.e. a VAS in the study group of 69 ± 14 mm before treatment vs. 40 ± 19 mm after treatment (p < 0.001), and in control subjects 66 ± 16 mm vs. 47 ± 17 mm (p < 0.001). No difference in level of pain intensity reduction between the groups studied was found.
  
  
  CONCLUSIONS
  Intensification of insulin treatment applied for five days results in improvement of the physical condition of patients with painful diabetic polyneuropathy, through pain relief, and improvement of the quality of life and sleep quality. The efficacy of insulin intravenous infusion and multiple injections is comparable.
authors.forename: Dominika
authors.initials: D
authors.lastname: Rokicka
authors.forename: Marta
authors.initials: M
authors.lastname: Wróbel
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Szymborska-Kajanek
authors.forename: Monika
authors.initials: M
authors.lastname: Adamczyk-Sowa
authors.forename: Anna
authors.initials: A
authors.lastname: Bożek
authors.forename: Krystyna
authors.initials: K
authors.lastname: Pierzchała
authors.affiliation: Department of Internal Medicine, Diabetology, and Cardiometabolic Diseases, Medical Faculty with Medical-Stomatological Division in Zabrze Silesian Medical University, Katowice, Poland. kstrojek@sum.edu.pl.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Strojek
mesh_terms: D000328:Adult; D000368:Aged; D003929:Diabetic Neuropathies / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D007328:Insulin