An option for painful diabetic neuropathy with simultaneous 'antioxidative' and 'anesthetic' properties: topical Citrullus colocynthis

Diabetic neuropathy is probably the most common complication of diabetes mellitus. Secondary preventive measures for diabetic neuropathy with delaying, stopping or even reversing progressive course of neuropathy, pain control and prevention of ulceration can play important role in diabetic patients care. Oxidative stress plays an important role in pathogenesis of diabetic neuropathy. Treatments for diabetic neuropathy have been mainly focused on two purposes, pain control and repair of nerve injury. Therapeutic options for nerve injuries may not improve or even exacerbate painful symptoms. On the other hand most of treatments for pain control have little or no effect on nerve function. As a result of mentioned discrepancy between ‘nerve protection’ and ‘pain control’ in the treatment of painful diabetic neuropathy, it is hypothesized that Citrullus colocynthis as a therapeutic agent with simultaneous antioxidative and anesthetic effects can play an important role in treatment of painful diabetic neuropathy. Previous in vitro and animal studies of C.colocynthis demonstrated its ‘antioxidative’, ‘anesthetic’ and ‘antiulcerogenic’ effects. A randomized controlled double-blind clinical trial is needed to evaluate this hypothesis. © 2014 GESDAV