Surgical Decompression for Diabetic Neuropathy in the Foot
Surgical Peripheral Nerve Decompression for the Treatment of Diabetic Neuropathy in the Foot
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Ontario
-
Sault Ste. Marie, Ontario, Canada, P6A 2C4
- Sault Area Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age >18 years
- Presence of Type 1 or 2 diabetes mellitus (fasting plasma glucose > 7 mmol/L or casual plasma glucose > 11.1 mmol/L and symptoms of diabetes or a 2hr plasma glucose in a 75g oral glucose tolerance test > 11.1 mmol/L)
- Symptoms of paresthesias (including burning pain) or numbness present symmetrically in both feet, determined to be on a peripheral nerve basis
- Total Neuropathy score of ≥ 2 based on symptoms, signs, and nerve conduction study abnormality
- Average pain on Likert scale (range 0 - 10) ≥5
- Good diabetic control with Hgb A1C < 8
- Presence of Tinel's sign at the Tarsal Tunnel
- Possession of valid Ontario Hospital Insurance Plan (OHIP) coverage
Exclusion Criteria:
- Other types of diabetes mellitus (gestational, drug-induced, etc.)
- Other cause of neuropathy than diabetes such as vasculitis, amyloidosis, toxic neuropathy, HIV, renal failure, alcohol abuse, etc. Pure entrapment neuropathy without evidence of DSP
- Symptomatic lumbosacral spine disease
- Symptomatic lower extremity vascular disease
- Previous foot ulceration or amputation. Other contraindications to surgery such as significant ankle edema, venous stasis, morbid obesity, or previous surgery/injury which would be incompatible with appropriate wound healing
- History of Peripheral Arterial Disease
- HbA1c > 8.0 - Adults lacking capacity to consent, pregnant women, prisoners, non-English speakers who require an interpreter, and those unwilling or unable to participate in the full study follow-up
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Surgical decompression
Surgical decompression of the common peroneal, tibial, and deep peroneal nerves
|
Surgical decompression of the common peroneal, tibial, and deep peroneal nerves
|
|
No Intervention: Standard medical care
Standard diabetic care and medical care provided for diabetic sensorimotor polyneuropathy
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
To determine if lower extremity nerve decompression in patients suffering from symptomatic diabetic peripheral neuropathy significantly alleviates pain.
Time Frame: 0,3,6, and 12 months
|
0,3,6, and 12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Neuropathic Symptoms as measured by the Total Neuropathy Score (TNS)
Time Frame: 0,3,6, and 12 months
|
0,3,6, and 12 months
|
|
Signs of peripheral neuropathy - two-point discriminations and pressure thresholds, vibration sensibility
Time Frame: 0 and 12 months
|
0 and 12 months
|
|
Nerve Conduction Velocity
Time Frame: 0 and 12 months
|
0 and 12 months
|
|
Quality of Life
Time Frame: 0,3,6, and 12 months
|
0,3,6, and 12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Timothy J Best, MD, MSc, Northern Ontario School of Medicine
- Study Director: Sante Fratesi, MD, MSc, Northern Ontario School of Medicine
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- DPNPSI-1
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