Diabetes & its Complications

Abstract

Clinical and Pharmacological Basis for the Use of Aliskiren in Diabetes Mellitus Patients with Peripheral Neuropathy

Archvadze Anna Sh, Kistauri Alexandre, Gongadze Nikoloz, Chirakadze Ketevan.

Statement of the problem: Diabetes mellitus is a challenging problem in modern medicine. Over 347 million people worldwide suffer from diabetes. Polyneuropathy is the most common complication of diabetes mellitus (60-70% of patients). Its treatment still remains unresolved. The optimal therapy involves: blood glucose level control, anticonvulsants, antidepressants and opioid administration, though it does not change pathogenic pattern. It has been identified that tumor necrosis factor alpha (TNF-α) and renin-angiotensin aldosterone system (RAAS) play a significant role in Type I and Type II diabetes development The data collected in the present-day scientific literature indicate the essential pathogenic role of TNF-α in the development of diabetic neuropathy (DNP). In our study we use Aliskiren (renin inhibitor) to study modulatory impact on TNF-α.

Methodology & Theoretical Orientation: The study population consists of 15 individuals diagnosed with diabetes mellitus (T2DM) with DNP. The enrolled subjects take Aliskiren during 6 weeks. At the start of the trial and on completion of the six weeks period TNF-α level and C-peptide will be determined.

Findings: Aliskiren improves conditions of T2DM patients with DNP. Namely, the symptoms of neuropathy are reduced, the blood TNF-α level is reduced and C-peptide level is increased.

Conclusion & Significance: Our results confirm hypothesis that TNF-α may play a substantial role in the development and progression of type 2 diabetes mellitus as well as in pathogenesis of diabetic neuropathy. Aliskiren has modulatory impact on TNF-α, so we have results for clinical and pharmacological analysis of Aliskiren application in diabetic neuropathy.