Diabetes Self-Management Blog

Roughly 60% to 70% of people with diabetes have some form of neuropathy (nerve damage); the risk for the condition increases the longer you’ve had diabetes. In fact, folks who have had diabetes for 25 years or more have the highest rate of neuropathy. Neuropathy is also more common in people who have difficulty controlling their blood sugar levels, are overweight, or who have high blood pressure or high levels of blood fat.

What causes neuropathy?
There are many factors that can lead to nerve damage, but in people with diabetes, it’s the constant exposure to high blood glucose levels that is likely the main culprit. Nerve fibers are very delicate. High glucose levels can interfere with nerve signal transmission, damage the nerves themselves, and also weaken the blood vessels that supply nerves with nutrients and oxygen.

Besides high blood glucose, other things like inflammation, genetics, injury, smoking, and alcohol use are thought to contribute to neuropathy.

What are symptoms of neuropathy?
The symptoms of neuropathy depend on what type it is. For example, symptoms of peripheral neuropathy — the most common type of neuropathy cause by diabetes, affecting the hands, feet, arms, or legs — include numbness, tingling, pain, weakness, and loss of sensation. Other types of neuropathy can cause symptoms such as dizziness or fainting upon standing, nausea, problems with urination, diarrhea or constipation, erectile dysfunction, and increased or decreased sweating. Always report any of these symptoms to your doctor.

How is neuropathy treated?
There’s no cure for neuropathy. Treatment includes lifestyle measures to slow the progression of nerve damage: blood glucose control, stopping smoking, increasing physical activity, and losing weight. In many cases, medicine may be needed to help manage symptoms such as pain or nausea.

How can nutrition help neuropathy?
Not surprisingly, good nutrition can go a long way in helping both to prevent and manage neuropathy.

Healthful eating. It should come as no surprise that following a healthful eating plan is a mainstay of preventing nerve damage in the first place. By controlling your portions and your carbohydrate intake, you’ll help better control your blood sugars, which, in turn, helps to limit or even prevent nerve damage. Make sure your eating plan includes a variety of foods. A dietitian can help you get on track with your eating if you’re not sure what to eat.

Vitamin B12. B12 deficiency is common among people who take metformin and among older adults. A lack of this vitamin may worsen peripheral neuropathy. Talk to your doctor about getting your B12 levels checked. If they’re low, you may need to take a supplement. In the meantime, include foods high in B12 in your diet, such as poultry, fish, lean meat, eggs, and fortified cereals.

Go vegan. If you have neuropathy and pain is a concern, you might consider trying a plant-based diet. In a recent study called DINE (Dietary Intervention for Chronic Diabetic Neuropathy Pain), people with Type 2 diabetes and neuropathy were assigned to either a low-fat, vegan (no animal products) diet with B12 supplements or B12 supplements alone (control group). The people following the vegan diet reported less pain and other neuropathy symptoms and improvements in A1C, cholesterol, and quality of life compared to the control group.

Go easy with alcohol. Alcohol may worsen neuropathy symptoms, such as numbness and pain. Drinking too much alcohol may also make it harder to control your blood sugar levels.

Ask about supplements. Certain dietary supplements may be helpful for easing symptoms of neuropathy. For example, alpha-lipoic acid, an antioxidant, has been used in Europe for years to treat peripheral neuropathy. Fish oil supplements may help improve blood flow and reduce inflammation. Curcumin (found in the spice turmeric) and evening primrose oil are other supplements that may help. Talk to your doctor about any supplement before you take it.

In addition to nutrition-related steps, explore other avenues for managing neuropathy, such as acupuncture, biofeedback, meditation, and relaxation techniques. While neuropathy may not go away, today there are newer and better ways for managing this complication.

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