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N/A N=44 Basic Science

Corneal Nerves Function and Structure

Diabetic Peripheral Neuropathy

Enrolled (actual)
44
Serious AEs
0.0%
Results posted
Jul 2024
Primary outcome: Primary: Cornea Sensitivity — 0.177; 0.293 time ratio of eyelids closed vs. open — p=<0.001

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Blackmores Omega Daily (4 1g capsules per day) (Dietary_supplement)
Age
Adult, Older Adult · 50+ yrs
Sex
All
Sponsor
VA Office of Research and Development
Primary completion
Jun 2023

Outcome Measures

OutcomeResultp-value
PRIMARY
Cornea Sensitivity
0.177; 0.293 <0.001 sig
SECONDARY
Change in Corneal Sensation Threshold Using Cochet Bonnet Filament
5.683; 5.953 <0.0025 sig
SECONDARY
Michigan Neuropathy Screening Instrument
5.720; 0.5455 <0.0001 sig
SECONDARY
Sensitivity to 10 g Monofilament Test
0.5577; 0.000 <0.0001 sig
SECONDARY
Presence of Vibratory Sensation of the Great Toe
0.6731; 0.000 <0.0001 sig
SECONDARY
Presence of Reflex
0.8125; 0.000 <0.0001 sig
SECONDARY
Visual Acuity
25; 20 <0.01 sig
SECONDARY
Questionnaires for Corneal Sensitivity
11.36; 1.09 <0.0017 sig
SECONDARY
Determination of Tibial Nerve Conduction Velocity
35.60; 50.50 <0.0195 sig

Summary

Peripheral neuropathy affects about 50% of the diabetic population and there is no treatment other than good blood glucose control, which is ineffective in subjects with type 2 diabetes. Part of the problem for the lack of an effective treatment is the inability to detect peripheral neuropathy in its early stage. The hypotheses to be addressed in the first phase of this study is that changes in cornea sensitivity (blinking and squinting) following addition of a hyperosmotic solution will provide a novel screening tool for early diagnosis of peripheral neuropathy. For the second phase of the study the investigators will examine the effect of fish oil treatment of diabetic subjects with neuropathy on corneal nerve density and sensitivity. Corneal nerves are the most highly innervated part of the human body with great sensitivity. The first phase will use this property and determine whether sensitivity is lost in diabetic patients with neuropathy. Preclinical studies have supported this hypothesis and now this will be tested in human subjects. Preclinical studies have also shown that treating diabetic rodents with fish oil improves nerve regeneration and outcome measures of peripheral in diabetic rodents. In the second phase the investigators will perform preliminary studies in human subjects with diabetic neuropathy and determine whether treating them with fish oil increases corneal nerve density and sensitivity.

Eligibility Criteria

Inclusion Criteria

  • Type 2 diabetes patients diagnosed based on the opinion of an Endocrinologist (Dr. Correia), the absence of a history of ketoacidosis, and a C-peptide > 0.8 ng/ml
  • At least 5 year known duration of diabetes.
  • HbA1c 100 mg/100ml, HDL 400 mg/100ml.* 10) BP < 140 systolic and 80 diastolic
  • BMI 45
  • Insulin use to manage diabetes 200 units
  • History of taking fish oil supplements
  • The investigators are limiting subject population to those over 50 thus pregnancy should not be an issue nonetheless females who are pregnant, looking to become pregnant or are breast feeding will be excluded (* After overnight fast of 8-12 h; Average of three determinations in the sitting position after at least 5 minutes rest.)
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04222660). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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