A large number of people in the New Orleans area have type 2 diabetes, a disease that affects nerves in the feet and legs. Diabetic neuropathy, which is nerve damage caused by high blood sugar levels, is the most common diabetes complication and one the Covington-based company Pamlab, LLC is working to address through medical research and development of a new treatment called Metanx.
Susan Doell a mother and fifth grade teacher, was diagnosed with type 2 diabetes in 2005. Within a year of her diagnosis, she noticed tingling sensations in her feet. Her diabetes was causing nerve damage.
"I started feeling the tingling," Doell says. "You don't notice it at first, because it's a slow onset. One day, it almost feels like pins and needles and then it gets to be where it's not as active. You don't feel that tingle anymore. "
Later, the sensation progressed to stabbing pains.
"You can be sitting there and then you just want to jump out of your skin — and it's only in one spot," Doell says. "I remember the first time I felt it. I was driving, and it was in my right foot, and (I was in) in the middle of Veterans (Memorial Boulevard). ... You just want to scream and holler and there's nothing you can do about it."
Dr. Vivian Fonseca, chief of endocrinology at Tulane Medical Center, says neuropathy is very common in people with diabetes. "About 60-70 percent of people sometime over their lifetime will have some nerve damage," he says. "Sometimes pain is good because it tells you there's something wrong, and if (people) don't feel it, it's very dangerous. Those people are at risk for amputations."
There are medications for neuropathy pain, and scientists at Pamlab believe they are the first to have a possible treatment for damaged nerves.
"Patients were starting to feel their feet again," says Harold Koch, senior vice president of scientific affairs and chief scientific officer of Pamlab, LLC. "(They) feel the tingling and burning they'd completely lost when they were at the stage of having no feeling whatsoever. They'd drive a nail through their foot and not even know they'd done it."
Metanx is a small purple pill containing a high dose of three types of vitamin B found naturally in food. Double-blind scientific studies were recently conducted at six sites across the U.S. to test Metanx. Fonseca was lead investigator, and findings are being reviewed by a scientific journal for possible publication.
"There was actually a small improvement with placebos because sometimes when you come in frequently to the doctor, you feel a little better. But there was a significantly better improvement with this drug," Fonseca says.
"We're not only treating pain to an extent, but we're also treating the actual condition itself by increasing the blood flow, bringing sensation back," Koch says.
Pennington Biomedical Research Center in Baton Rouge performed the same study on rats and could see improvements in the rodents' nerves' structures.
Since starting on Metanx, Doell says walking and other daily routines are easier. "When I'm not on it, I know that there's a difference," Doell says.
Because Metanx is not the synthetic or over-the-counter supplement form of vitamin B, it requires a prescription. The pills cost $80 a month. Some insurance companies pay a small amount toward the cost, and patients take one pill twice a day.
Another free follow-up study on Metanx starts in February. Doctors are looking for people with diabetes who have nerve pain, numbness, tingling and/or burning, and shooting and/or stabbing pains in their feet. For information about the study can call (888) 831-7333.
Look for Meg Farris' Medical Watch reports weeknights on WWL-TV Channel 4 and any time on wwltv.com.
Many foot complications can be prevented with thorough care. Here are some foot-care tips for diabetes patients.
1. Check feet daily for cuts, sores, bruises or any abnormalities. Use a mirror or have a family member assist you if needed.
2. Wash feet daily using warm water and soap. Hot water can burn your hands and feet without you realizing it because of nerve damage, so test water temperatures first with your elbow.
3. If your feet are cold at night, wear socks. Do not use a heating pad or hot water bottles.
4. Never go barefoot, especially outdoors.