Spinal Cord Stimulation for Diabetic Peripheral Neuropathy
By Arvind SommiMatthew GarzaArmaan Nallicheri
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The FDA approved Medtronic’s spinal cord stimulators for the treatment of chronic pain from diabetic peripheral neuropathy (DPN). Learn more about these devices and how they address the pain from DPN.
In January, the FDA approved two of Medtronic’s existing technologies, Intellis and Vanta, for the treatment of pain associated with diabetic peripheral neuropathy (DPN).
DPN is a complication that affects approximately 30% of people with diabetes. DPN occurs when high glucose levels damage nerves in the extremities such as the hands, legs, and feet.
While the symptoms of DPN vary from person to person, many describe them as numbness, tingling, or burning sensations that start at the toes or fingers and move upward. This initial sensation may, over time, progress. People with diabetes who have DPN are at greater risk of amputation. This is especially true for those who have peripheral arterial disease, infections of the legs, trauma which they may not feel, or foot ulcers which may go unnoticed.
Currently, treatments for DPN primarily consist of managing glucose levels and improving Time in Range, as well as certain medications designed to address the painful symptoms of DPN. However, for about 800,000 people with diabetes living in the US with DPN, these options may not be enough – especially given the side effects that come with the currently available drugs for pain.
To address this gap in available treatment options for painful DPN, Medtronic developed two new technologies named Intellis and Vanta.
What are Intellis and Vanta?
Both of these technologies are neurostimulators. Intellis is a rechargeable spinal cord stimulator that can give higher doses of electrical stimulation, while Vanta is a recharge-free spinal cord stimulator that can deliver weaker electrical pulses for years without requiring any charging. Although these devices were already approved for several chronic pain conditions, the FDA recently indicated that they can be used to treat pain from DPN as well.
These spinal cord stimulators are fully implanted in the body and work by stopping pain signals before they reach the brain – reducing the painful symptoms often associated with DPN. Although this treatment does not address the underlying causes of or cure DPN, this pain reduction can lead to significant improvements in quality of life.
Several studies have shown that these types of neurostimulators are effective in treating the pain of DPN. In this study those people treated with spinal cord stimulation had a reduction in their pain, as well as improved health and quality of life after six months when compared to those in the control group not receiving this treatment. In a long-term follow up study, 47% of people treated reported a 50% pain reduction during day and 35% of people treated reported this pain reduction overnight at 24 months.
When will Intellis and Vanta become available for people with diabetes?
The devices are already on the market; the recent FDA approval simply allows them to be used for treating pain from DPN as well as certain other neuropathic conditions. Talk to your healthcare team to see if this therapy could help you manage chronic DPN.
To learn more about neuropathy, check out our infographic.
