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Diabetic Neuropathy Improved with Vegan Diet

A randomized controlled trial indicates that a vegan diet may be beneficial in relieving diabetic nerve pain…. 

Diabetic peripheral neuropathy, which occurs in about half of all patients with type 2 diabetes, is underdiagnosed, and this is partly because physicians aren"t able to offer anything to treat the underlying cause of this condition, and the current treatments provided to these patients only treat the pain. The vegan diet is a plant-based diet, and studies show that it can help ease the pain caused by diabetic neuropathy. In an earlier observational study conducted by Crane and Sample, 21 type 2 diabetes patients with nerve pain were put on a low-fat, high-fiber vegan diet for 1 month, and 81% of the participants achieved complete pain relief and lost around 11 lbs on average. Additionally, the diet enabled most of these patients to reduce their diabetes medications and blood pressure medications.

Anne Bunner, PhD, and Caroline Trapp, MSN, of the Physicians Committee for Responsible Medicine, sought to see whether these same benefits could be seen in a randomized controlled trial. They conducted the Dietary Intervention for chronic diabetic Neuropathy pain (DINE) study, in which 15 patients with type 2 diabetes and diabetic neuropathy were randomized to either a low-fat, high-fiber, vegan diet and B12 supplementation or B12 supplementation alone. The patients had a mean age of 57, half of them were female, and half had a college education or higher. Bunner noted that there tended to be a deficiency in B12 in diabetic patients, especially those taking metformin. The participants who were put on the diet had to attend 20 weekly nutrition classes involving nutrition education, social support, cooking demonstrations, and food product sampling, eat plant-based foods that had a low glycemic index, get at least 40 grams of fiber per day, and limit their consumption of fatty foods, such as oils and nuts, to 20-30 grams per day. Since high-fiber foods were low in calories, there were no portion limits.

Five out of the seven patients that were put on the vegan diet were fully adherent. According to Bunner and Trapp, with good adherence, the participants that were put on the diet along with the vitamin reported greater improvements in McGill Pain Questionnaire pain scores (p=0.04) and significantly greater reductions in body mass index (p=0.01) when comparted with the control group.

The results of the study indicated that there were also improvements in cholesterol, HbA1c, neuropathy symptom scores (NTSS-6), and quality-of-life scores in which the changes differed significantly from the baseline, but these improvements were not significantly greater in the diet group when compared to the control group. There was a greater decrease in cholesterol and HbA1c in the diet group, but many of the patients in the diet group discontinued their lipid medications and diabetes medications, while those in the control group were put one more lipid medications and diabetes medications, so the graphs were artificially lowered. Participants on the vegan diet had significant improvement in NTSS-6 and similar changes in quality-of-life scores not matched by the control group, but at the end of the trial, the differences among both groups were not significant, which Bunner believes may have possibly been due to the small number of patients or maybe even the effect of participating in the study on the control group. The researchers plan to follow their study participants for 1 year to examine the long-term effects exhibited in these patients. They believe the study has shown that a dietary intervention can provide promising potential for treating diabetic nerve pain.

Practice Pearls:
  • In this study, the patients with type 2 diabetes and diabetic neuropathy that were randomized to a low-fat, high-fiber, vegan diet and B12 supplementation reported greater improvements in McGill Pain Questionnaire pain scores and significantly greater reductions in body mass index than the patients receiving the B12 supplementation alone.
  • The control group also resulted with improvements in cholesterol, HbA1c, neuropathy symptom scores (NTSS-6), and quality-of-life scores in which the changes differed significantly from the baseline, but these improvements were not significantly greater in than the control group.
  • The researchers believe that the results of this study have shown that a vegan diet can provide promising potential for treating diabetic nerve pain.