Diabetic neuropathy is weird. It’s also called diabetic nerve pain but I’ve seen it take forms other than pain … tingling or itchiness, a sense of cold or hot, even burning, a feeling of bugs crawling on your arms and legs, numbness and loss of feeling that comes and goes. That’s in the extremities, the fingers, toes, arms, and legs. Neuropathy also goes on inside the body, in the gastrointestinal tract (bloating, difficulty swallowing, gastroparesis which is difficulty emptying the stomach, sluggish bowels/constipation or diarrhea), in the brain (dizziness, memory problems, insomnia), the urinary tract (dripping or incontinence), the sexual organs (erectile dysfunction), the eyes (blurry vision). It’s pervasive. No tissue or organ that is innervated is left untouched.
Diabetic neuropathy doesn’t just develop in people with diagnosed diabetes. It’s happening in people on their way to getting diabetes … people with prediabetes, impaired glucose tolerance, impaired fasting glucose, people who don’t yet know they have metabolic abnormalities, people who think their indigestion was from eating gluten-containing bread, or their tingling fingertips are from wrapping dental floss too tightly. In fact, it’s the sensations of neuropathy that often send people to the doctor and lead them to discover their diabetes.
Antidepressants, analgesics, and good glucose control can lessen pain, but there isn’t a therapy that treats the underlying cause.
However … There was a small study several years ago that found complete pain relief in 81% of participants who ate a low-fat (10-15% of calories), high-fiber, vegan diet:
Regression Of Diabetic Neuropathy With Total Vegetarian (Vegan) Diet, Journal of Nutrition and Environmental Medicine, 1994
“This study reports alleviation of the sharp, burning pains characteristic of systemic distal polyneuropathy (SDPN) patients with adult-onset (Type II) diabetes mellitus (AODM).
Twenty-one patients with known AODM and SDPN, average age 64, were trained in a low fat (10–15% of cats), high fiber, total vegetarian diet (TVD) of unrefined foods and conditioning exercise in a 25-day in-residence life-style program.
Complete relief of the SDPN [neuropathy] pain occurred in 17 of the 21 patients in 4 to 16 days. The numbness persisted, but had noticeably improved. Weight loss averaged 4-9 ± 2-6 kg during the 25 days. By the 14th day, the fasting blood glucose level averaged 35% lower for the 11 patients who were above 6-6 mmoll1, and the insulin needs had dropped in half the patients. Five no longer needed hypoglycemic agents. Also, serum triglyceride and total cholesterol had decreased by 25-0 ± 23% and 13 ± 15% respectively (p <0-01) in 2 weeks.
Follow-up studies of 17 of the 21 patients for 1-4 years indicated that 71% had remained on the diet and exercise programme as advised in nearly every item. In all except one of the 17 patients, the relief from the SDPN had continued, or there was further improvement.
In our opinion, these results appear to be related to a factor(s) in the TVD, and not necessarily to an improved glucose control, since the serum glucose was not under good control until about the 10th day.”
So, there was something about the diet, apart from its ability to lower blood glucose, that reduced pain. This, to me, is the kind of startling finding that should have been pursued. Twenty years later, it’s still being reproduced. Here’s a presentation from this year’s annual meeting of the American Association of Diabetes Educators:
A Dietary Intervention for Chronic Diabetic Neuropathy Pain, American Association of Diabetes Educators Annual Meeting, 6 August 2014
Vegan Diet Eases Diabetic Neuropathy Pain, MedPage Today, 8 August 2014
Bunner et al. conducted a small trial in patients with type 2 diabetes and diabetic neuropathy. Patients (n=15, mean age 57) were randomized to either a low-fat, high-fiber (goal: 40 grams), plant-based diet plus vitamin B12 supplementation, or to B12 supplementation alone.
With good adherence (five of seven diet patients were fully adherent), those on the diet had significantly greater improvements in McGill Pain Questionnaire scores than those on B12 alone (P=0.04), Bunner said.
They also had significantly greater reductions in body mass index (BMI) compared with controls (P=0.01).
There were other benefits to the plant-based diet but since the study was so small and since medication changes weren’t consistent across groups (e.g. both lowered cholesterol but those on the plant diet lessened lipid drugs, while controls increased lipid drugs) it was difficult to ascertain an effect.
Go back and look at the symptoms at the beginning of this post and tell me they’re not worth trying a low-fat, whole food, plant-based diet.