TITLE: Acupuncture and Diabetic Neuropathy among Native Americans Native Americans are at high risk for developing type 2 diabetes and a common complication of diabetes, peripheral neuropathy (DPN), The symptoms associated with DPN are typically debilitating, reduce quality of life, and can lead to amputation in the affected limb. Acupuncture has been shown to improve microcirculation measured in healthy volunteers, however this association has not been tested in patients wjth neurovascular disease, in particular those with DPN. In the Prevalence Study, all consecutive patients seen at the Indian Health Council (IHC) Diabetes Clinic over a one year period (approximately 500) will be assessed for clinical peripheral neuropathy, diagnosed using the Neuropathy Disability Score (NDS) and the Neuropathy Symptom Score (NSS). In the Intervention Study. 60 adult diabetic patients with peripheral neuropathy attending the IHC Diabetes Clinic wil) be. randomized to acupuncture treatment or sham acupuncture (placebo), once per week over a 10-week period. Microcirculation/endothelia) activity will be assessed by laser Doppler f luxmetry (LDF) at baseline, immediately after 10 weeks of intervention, and 10 weeks after treatment ends. The standardized Neuropathy Total Symptom Score-6 (NTSS-6) questionnaire will be used to assess symptomatology at the same three points of time. Baseline characteristics of the study cohort (such as age, gender, body mass index, medication use, diabetes severity and control) will be evaluated. It is anticipated that those treated with acupuncture will experience improved microcirculation/endothelial activity as well as fewer symptoms of neuropathy, when compared to those receiving the sham procedure. Nerve damage is a common complication of diabetes that can cause pain and numbness in the hands and feet, and lead to amputations. Acupuncture may be a cost-effective way to treat symptoms of this nerve damage and to prevent more severe complications. In a sample of Native Americans, who are at particularly high risk of diabetes and subsequent nerve damage, acupuncture will be tested as a possible treatment.
