Jalaukavacharana (Leech Therapy) in the Management of Diabetic Peripheral Neuropathy – A Case Series

A BSTRACT Diabetic peripheral neuropathy (DPN) is a leading cause of disability in diabetic patients. About 25% of diabetics will have peripheral nerve issues within a decade. Diabetic foot ulceration begins with peripheral neuropathy. Failure to diagnose this illness may result in foot deformity, gangrene, and land up in amputation. Less than 40%–60% of DPN patients respond to symptomatic treatments. The most common neuropathic treatments include antidepressants, anticonvulsants, topical lidocaine, and opioids which often have side effects. Consequently, numerous treatments for this disease have been suggested. Bloodletting, also known as Raktamokshana , is a traditional Ayurvedic para-surgical technique described by Acharya Sushruta for the treatment of various diseases. Leech therapy has become famous worldwide due to its therapeutic advantages. Leech saliva includes around 100 enzymes with various actions, including anti-inflammatory, anticoagulant, analgesic, antibacterial, vasodilator, wound healing, and anesthetic activities. This case series included five DPN cases treated with leech therapy, six sittings each at a 7-day interval. All five cases were assessed before and after completion of treatment by the Michigan Neuropathy Screening Instrument (MNSI)-Health questionnaires. Physical examination with MNSI and a specifically designed electronic machine neuropathy analyzer was done. Leech therapy led to fast and significant symptomatic relief in prevalent complication like DPN as found in five cases.