Of all diabetic complications, neuropathy is one of the scariest and most difficult to treat. Nerve damage in the feet, leading to numbness or pain and, in severe cases, to foot ulcers or amputations, affects up to 60 percent of diabetics, according to recent research.
Various kinds of treatment are available, many of them treating the pain of neuropathy. But the real challenge of the complication isn’t pain — it’s the loss of sensation itself. That’s what can lead to the worst outcomes, and it’s what a medical product called Metanx aims to treat.
Manufactured by Louisiana-based Pamlab, Metanx is a medical food, a substance available by prescription that works to improve blood flow in the small blood vessels that keep nerves in the feet responsive.
The product has shown success in scientific trials.
“Research has demonstrated a significant increase in epidermal nerve fiber density after six months of Metanx treatment,” the company says, and research is continuing. A study published late last year in Reviews in Neurological Diseases suggested that patients treated with the medical food regained some sensation lost to neuropathy.
What’s in a tablet of the product? It’s essentially a vitamin, but one that contains active forms of nutrients that the body can use. Most B vitamins bought over the counter have to be converted by the body into their active forms to have any benefit.
That can mean that patients who take vitamins for their health sometimes don’t get all of the benefits — according to Pamlab, nearly half of the population can’t fully translate folic acid into its active, beneficial form: L-methylfolate. Metanx does the job on its own, and adds in some other vitamins for good measure.
Company literature says that “the bioefficacy of one Metanx tablet can be compared to taking 19 folic acid tablets (1 mg each) two B12 tablets (1 mg each), and two B6 tablets (25 mg each).”
Pamlab has recently raised the alarm about a vitamin combination being prescribed as a generic alternative to Metanx. It strongly disagrees with the switch, writing in an open letter that the alternative doesn’t contain an active form of folate and, indeed, doesn’t appear in a listing of FDA-approved generic drugs.
The best advice for diabetics, of course, is to keep tight control to prevent complications from happening at all. Regular visits with your doctor can help detect problems early on. But the prescription treatment available through Metanx offers another avenue of care for patients and physicians.