New Approach for Neuropathy Pain?

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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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