Jan. 7, 2004 -- Each year in the U.S. nearly 90,000 diabetes patients lose toes, feet, and legs to amputation. Even minor foot trauma can lead to major problems caused by diabetes-related nerve damage, medically known as neuropathy.
Now early research offers hope that an over-the-counter cream can help save the lower limbs of people with diabetes. The cream contains the amino acid arginine, and the newly published study shows that it dramatically improves blood flow to the feet of patients with type 2 diabetes.
American Diabetes Association (ADA) vice president Robert Rizza, MD, calls the findings from the small study "intriguing but preliminary," and says the next step is to determine if the cream can actually prevent or lessen the foot complications that lead to diabetes-related amputations.
"This pilot study showed that arginine does increase blood flow, but it is not yet clear if this translates into fewer foot ulcers or better healing of ulcers," he tells WebMD.
35% Improvement in Blood Flow
Up to 70% of all diabetics have some degree of nerve damage caused by the disease, with numbness, tingling or pain in the extremities being some of the common symptoms. Diabetes is the leading cause of nerve damage, it accounts of 50-75 % of nontraumatic, preventable foot amputations.
Foot problems can be among the most common and troublesome complications of diabetes. Government statistics show, 15% of diabetics will develop foot ulcers, and as many as one in four of these patients will eventually require amputation. Diabetes-related foot ulcers occur because of neuropathy and vascular disease.
Arginine is a naturally occurring amino acid that is a precursor of nitric oxide, which has been shown to control blood flow by relaxing the smooth muscle cell lining of the blood vessels causing blood vessels to dilate. In the study, published in the January issue of the ADA journal Diabetes Care, the arginine-containing cream was compared to a placebo cream in 13 patients with type 2 diabetes.
Researcher Eric T. Fossel, PhD, says foot blood flow increased by 35% with use of the arginine cream over the course of the trial, and big toe temperature increased by an average of 8 degrees.
"That is a huge amount," he tells WebMD. "It is true that this was a small study, but these are very convincing statistics."
Fossel, who is a former Harvard University chemistry professor, has patented his arginine formulation and sells it on the Internet under the name HealthiBetic. He says it will be available in drugstores within a few months.
Taking Care of Your Feet
Rizza says the arginine cream is the latest in a long line of topical formulations and oral medications that were supposed to reduce the limb complications associated with diabetic neuropathy. Most, he says, have not worked well.
"We need better treatments, but there are many things that diabetics can do to reduce their risks," he says.
Among the most important:
- Inspect your feet daily. Diabetes patients with neuropathy should check their bare feet every day for red spots, cuts, swelling, or blisters. People who can't see the bottoms of their feet should use a mirror or ask for help.
- Keep your blood sugar under control. People with poor blood glucose control are at increased risk for developing nerve and vascular damage.
- Get moving and don't smoke. Exercise helps improve blood flow to the feet, and smoking makes arteries harden faster.
- Never go barefoot. Wear comfortable shoes or slippers that fit well and protect the feet. Also check shoes for rough seams, sharp edges, pebbles, or other foreign objects before putting them on.