MANAGEMENT OF DIABETIC NEUROPATHY BY IRSAL-e-ALAQ (HIRUDOTHERAPHY): A CASE REPORT

Dr. Fatima Khan*, Prof. Abdul Nasir Ansari and Dr. Mohd Nayab

ABSTRACT

Background: Diabetic Neuropathy is a serious and common complication of diabetes and causes substantial morbidity as well as increases mortality. The primary underlying cause is a thickening of the capillary basement membrane with associated increased vascular permeability and micro-thrombi. In the Unani System of Medicine, no direct concept of diabetic neuropathy is mentioned; but neuropathy has been described under the caption of Khidr. Razi (Rhazes) has mentioned in his book Al Ḥawi Fit Tib the concept of Khidr and its occurrence in those tissues, which are somato-sensory in nature. The conventional system of medicine offers limited clinical evidence for its effectiveness. Hence, it can be managed well by one of the Unani regimens, i.e., Irsal-e-Alaq (Hirudotherapy). Objective: The purpose of this case report is to provide insight into the effects of Irsal-e-Alaq (Hirudotherapy) in Diabetic Neuropathy. Intervention: A 61-year-old male who has complaints of numbness in the left foot with neuropathic ulcer and was a known case of diabetes mellitus for 15 years on insulin. Two leeches were applied once in a week for nine weeks. Telephonic follow-ups were continued for two and a half months after completion of treatment for any re-occurrence of any of the signs and symptoms again. Results: Michigan Neuropathy Screening Instrument (MNSI) was used to find out the improvement in neuropathy. On day 0, the MNSI was 4 and 1 on 58th day. The sensation in the foot was restored completely within 58 days as well as the size of the wound also reduced with subsequent sittings of Irsal-e-Alaq. Conclusion: Irsal-e-Alaq is found effective in the treatment of diabetic neuropathy as well as in improving the quality of life in such patients. Hence, rigorous, controlled, randomised, blinded and long duration follow up studies on large sample size need to be conducted by trained clinicians or researchers to establish the efficacy of Irsal-e-Alaq in the treatment of diabetic neuropathy.

Keywords: Diabetic Neuropathy; Irsal-e-Alaq; Hirudotherapy; Ziyabetus.