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Systemic Contact Dermatitis: Diagnostic Challenges in 2002 The loss of sensation in limbs, hands, and feet is one of the three most serious side effects of diabetes. (The other two are diabetic retinopathy, which affects the eyes, and diabetic nephropathy, which impacts kidney function.) Known as diabetic peripheral neuropathy, or DPN, this condition affects the nerves in the extremities and can lead to tingling, numbness and pain and, in advanced cases, may require amputation of hands and feet. Until recently, there was not much hope of treating diabetic neuropathy once it began; only the traditional methods of controlling glucose and frequent examinations were available options. With over 150 million diabetics across the globe and projections that this figure could double in the next few years, developing a means of limiting and/or reversing DPN has become a critical issue. The implications of diabetic peripheral neuropathy reach far beyond the immediate human impact on the diabetic and his or her family; the social and economic implications, both in the United States and worldwide, are of grave significance as well. New research, however, has indicated that hope may well be on the horizon for diabetics who show symptoms of neuropathy. A new drug, LY333531, has demonstrated positive results in treating DPN. Research has established that PKC (protein kinase C) Beta, an enzyme produced in the body, is involved in the overall process that leads to diabetic neuropathy. The theory is that if PKC Beta production could be blocked, the effects of DPN might be slowed or even reversed. During a recent annual meeting of the American Diabetes Association, a team headed by Dr. Aaron Vinik announced significant results of recent clinical trials utilizing LY333531. In a yearlong clinical trial of the drug, Dr. Vinik and his team found improvement in DPN patients, as measured by neurological tests, physician evaluations and other objective tests of nerve functioning. Vinik and associates noted that, while elevated blood sugar found in people with diabetes triggers PKC Beta production, LY333531 was a positive factor in improved nerve function and other sensory measures. The group also felt that, based on these early trials, patients experiencing the early signs of diabetic neuropathy would benefit most from LY333531 treatment. More clinical trials for this medication are scheduled for this year and the next and the manufacturer of the drug, Eli Lilly, plans to seek FDA approval for its use as a treatment for diabetic neuropathy in 2004. Though still in the testing stage LY333531 promises a significant breakthrough in treatment for DPN and a positive impact in the lives of diabetic patients everywhere. References Business Wire. (2002, June 17). Data presented at ADA reveal Lilly's PKC Beta inhibitor improved symptomatic diabetic peripheral neuropathy: Lilly plans U.S. regulatory submission in 2004. Retrieved July 4, 2002, from http://www.businesswire.com/webbox/bw.061702/221682274.htm. Vinik, A., Tesfaye, S., Zhang, D., & Bastyr, E. (2002, June 17). LY333531 treatment improves diabetic peripheral neuropathy (DPN) with symptoms. Presented at 62nd Scientific Sessions of American Diabetes Association, San Francisco (abstract #321).

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