Diabetes Self-Management Blog

Pain from diabetic neuropathy can be debilitating for people who have the condition, and it can be difficult to treat, with only an estimated 40% to 60% of those affected achieving partial relief. But based on the results of a small, ongoing, randomized trial presented at the American Association of Diabetes Educators 2014 Annual Meeting & Exhibition, a low-fat, plant-based diet may be able to control the pain caused by this complication.

Neuropathy, or nerve damage, affects up to 70% of people with diabetes, according to the National Diabetes Information Clearinghouse. In people with diabetes, neuropathy is typically caused by high blood glucose levels, but other causes include vitamin B12 deficiency (which is particularly common in people taking the diabetes drug metformin), cancer, injury, and certain drugs.

Peripheral neuropathy affects the nerves responsible for sensation and typically impacts the feet, legs, hands, and arms. Symptoms include pain, numbness, loss of sensation, tingling, coldness, and sensitivity to touch. (Another type of neuropathy, autonomic neuropathy, impacts nerves that control the functions of internal organs, and may cause complications ranging from gastroparesis to sexual dysfunction.)

A previous study showed that a low-fat, high-fiber vegan diet (which includes only plant-based foods and avoids anything derived from or produced by animals) completely relieved neuropathy pain in 81% of the subjects, who also lost roughly 11 pounds, on average.

To determine the effect of a plant-based diet on diabetic neuropathy pain, researchers from the Physicians Committee for Responsible Medicine recruited 35 people with Type 2 diabetes and neuropathy for the Dietary Intervention for Chronic Diabetic Neuropathy Pain (DINE) study. The participants had a mean age of 57, and about half were female.

The subjects were randomly assigned to either a low-fat, plant-based diet along with vitamin B12 supplementation or vitamin B12 supplementation alone. Those on the diet were instructed to eat only plant-based foods, get at least 40 grams of fiber each day, choose foods with a low glycemic index (a ranking of how much a food raises blood glucose levels), and limit fatty foods such as oils and nuts to 20 to 30 grams per day. (No portion limits were in effect for other foods.) Participants in the diet group also attended 20 weekly classes involving nutrition education, social support, cooking demonstrations, and food product sampling.

The researchers found that the 17 participants in the diet group had significant improvements on the McGill Pain Questionnaire (a self-reported pain scale) compared to those receiving B12 supplementation alone. The diet group also had significant improvements A1C (a measure of glucose control over the previous 2–3 months), as well as in neuropathy symptom scores and quality-of-life scores, but these differences were not significant at the end of the trial compared to the control group — “possibly because of the small number of patients or because of the effect of participating in a study on the control group,” according to the researchers.

“Diabetic peripheral neuropathy is underdiagnosed, partially because there’s not a whole lot for physicians to offer these patients,” noted study author Anne Bunner, PhD. The findings, she notes, indicate “the potential of a low-fat vegan diet as a treatment for diabetic neuropathy pain.”

The researchers plan to follow the participants through one year and report on the longer-term effects of the plant-based diet.

Because the study has not yet been published in a peer-reviewed journal, the findings should be considered preliminary.

For more information, read the article “Vegan Diet Eases Diabetic Neuropathy Pain” or see the presentation’s abstract on the website of the American Association of Diabetes Educators. To learn more about managing neuropathy pain, read the articles “Coping With Painful Neuropathy” and “Controlling Neuropathic Pain.” And to learn more about adopting a plant-based diet, see the piece “Adopting a Vegetarian Meal Plan: An Option to Consider.”

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Comments
  1. I am curious, have there been any similar studies with regard to autonomic neuropathy?

    Posted by Bruce |
  2. It is too bad that this study reduced sugar, fat and animals). I’d like to see a study that included good saturated fats from foods like nuts (including coconut oil for cooking), avocados, olives, etc. while still being plant based (hopefully, low in pesticides). By removing the sugars in the packaged foods, I suspect that one would have just a successful result. Ideally, there would be another group that had the good fats for which we could compare. I also suspect that if there was a group including pastured animals that we would also have a good result. The combination of factory farming on our dairy and meats along with the added sugar, salt and polyunsaturated fats in our packaged foods is destroying our bodies. I’d like to see yet another group that included, not only healthy plant based fats, but also healthy animals.

    Posted by Sam |
  3. Of course it is better to try and prevent Neuropathy in the first first — keeping your blood sugar as close to normal as possible is the only known way. I can say (from experience) that it can be mostly reversed with close to normal glucose levels, but it takes a long time (years).

    Posted by JohnC |
  4. @Sam This study did include fats from nuts. It was just specifically limited to 20-30 grams per day.

    Posted by Heather McFarland |
  5. While this diet is all good to try and prevent neuropathy and conditions like Gastroparesis, once you have Gastroparesis, this diet in no way works. We cannot digest near the amount if fiber, my diet is lucky to contain 10g a day and no fresh vegetables because they are not digested well either and without animal fats then the lower gi tract becomes blocked and the effects on hair and nails are profoundly deficient. While lowering sugar is also great, most low fat or light foods and beverages contain artificial sweeteners or plant based sweeteners like stevia leaf now added to an enormous amount if low fat and light foods and beverages, are known migraine triggers and cause painful reflux, gerd and heartburn. The Gastroparesis diet and the diabetic diet are not compatible at all and we are left to simple carbs with lower fiber, easily digestible canned vegetables and even baby food for easier digestion. So your studies may ease peripheral neuropathy but will truly complicate eating at all for the Gastroparesis patient.

    Posted by Jeannie |
  6. I would guess there are not too many Vegans if any at all that are type2 diabetics.
    So if someone could adhere to a Vegan lifestyle or desire one, they most likely would not have become a type2 diabetic.
    Point being this is not a very realistic solution.
    For example, I choose to live a short pain filled life eating bacon, sausage, spam, and eggs versus becoming a vegetarian with an extended life span.
    Plus I am sure if I could adjust my current diet to somehow get 40 grams of fiber a day (no onions or green peppers please) and limit myself to 20 grams of sugar, I would reduce my daily pain.

    Posted by Paul J Okrzesik |
  7. Hi Diane,

    I have Type II diabetes (about 20 years) and have a bit of neuropathy pain in my toes. What I find is that this becomes acute during winter and eases up during summer. I am a vegetarian, and try and consume a low fat diet. Is there a link between ambient temperature and neuropathic pain?

    Regards,

    Krishna Kumar

    Posted by Krishna Kumar |
  8. I am getting pain on my body i.e. Legs, Hands, Arms, Waist, Shoulders & Neck. Pl suggest me for getting relief from this pain.

    Posted by Baisakhu Deep |
  9. I had PN in my feet … it was excruciating! Now I’m 100% pain free in my feet … and it didn’t take long. How did I do it?

    1. Got my B/G under control.
    2. Took Super Complex Vitamin B tablets (NatureMade)twice daily … morning and evening.
    3. Additionally took one NatureMade Vitamin B-12 once daily in evening.
    4. Used essential oil pain relief as needed … Reunion Intense Spot Relief and foot cream. Terrific!

    I still take the vitamins and use the foot cream daily as I sure don’t want PN again!

    5. I take Meriva-SR Curcumin twice daily for inflammation and Geneve Sylvestre herb (GNC)for B/G control.

    I don’t eat a lot of carbs or sugar but other than that, I pretty well eat what I like sparingly.

    Good Luck to All!

    Posted by Karl Zetmeir |

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Diane Fennell
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