Sajid Nisar, Azhar Hussain, Ambreen Butt, Mehwish Azhar, Faisal Masud.
Comparison of Efficacy of Topical Glycerin Trinitrates with Capsaicin in Painful Diabetic Neuropathy.
Esculapio J Services Inst Med Sci Jan ;7(2):32-7.

Objective: To compare the efficacy of topical glycerin trinitrates with capsaicin in painful diabetic peripheral neuropathy. Material & Methods: This quasi experimental study was conducted in Diabetes Management Centre Medical Unit-IV Services Hospital, Lahore over a period of six months from 01-06-2008 to 30-11-2008. Sixty-two patients of diabetes mellitus having symptoms of neuropathy were included in this study and were divided into two groups of thirty one patients each. In group A topical capsaicin cream was applied twice a day for thirty minutes for the period of seven days at the strength of 0.075% w/w. In group B glycerin trinitrate cream was applied twice a day for thirty minutes for the period of seven days at the strength of 2% w/w. After seven days of treatment, intensity of numbness and paraesthesia and tissue perfusion were again assessed using visual analogue scale and periscan respectively. Periscan and visual analogue chart assessment were repeated after the seven days wash out period and patients were crossed over to the other treatment group. Numbness and paraesthesia were reassessed at the end of last treatment on visual analogue chart and periscan were repeated as well for tissue perfusion. Results: The age of the patients in group A was 49.90±8.06 years and in group B was 49.58±6.62 years. In group A, the efficacy of GTN in peripheral neuropathy was 38.7% as compared to capsacin which was only 19.3%. Similar results were seen in group B, in which efficacy of GTN in peripheral neuropathy was 51.6% as compared to capsaicin that was 29%. The overall results when combined in both the groups showed a response to capsaicin in 15 (24.2%) patients only versus 28 (45.2%) to GTN. This difference was statistically significant (p=0.02356). Conclusion: There is a significant difference in efficacy of topical glycerin trinitrates and capsaicin in the management of diabetic peripheral neuropathy. GTN cream, a well-tolerated drug, provides significant improvement in painful diabetic neuropathy.

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