Last week we spoke about diabetic nephropathy (kidney disease resulting from diabetes).  This article is the last in the series that deals with complications of diabetes.  The next article in the series will deal with lifestyle interventions.

ALSO READ : Turning the Tide – Understanding Diabetes (part 7)

What is neuropathy?

In its simplest definition, it is basically damage to nerves.  The nervous system is classified as the Central Nervous System (which includes the brain and spinal cord) and the Peripheral Nervous system (the nerves coming from the brain directly or from the spine). Neuropathy generally refers to damage to the peripheral nerves.

This condition often presents with tingling of nerves, numbness or loss of sensation, or chronic pain.  If it affects the autonomic nerves that control bodily functions, it can present with heart rate abnormalities, blood pressure abnormalities, gastro-intestinal or bladder symptoms.

What causes neuropathy?

There are many factors – trauma, nutritional deficiencies, toxins (including medications such as some cancer medications, but more commonly by alcohol), certain infections – but the most common is diabetes.  It is estimated that up to 60% of peripheral neuropathy is caused by diabetes.  Diabetes damages the tiny blood vessels that feed the nerves.  The actual mechanism is unknown, but it is thought to be due to high blood sugar levels.

Here is an interesting article that gives more details:

How common is diabetic neuropathy?

It is estimated that around 50% of people with diabetes (both Type 1 and Type 2) will develop diabetic neuropathy.

Factors that can increase this incidence include smoking, how well the diabetes is controlled, concomitant alcohol use, poor nutrition, and length of time a person has had diabetes.

What complications can occur from diabetic neuropathy?

If peripheral sensory nerves are affected, this can result in painless injuries and burns, which may lead to gangrene and amputations.  Pain is a protective mechanism to keep us from injuries.  But if you can’t feel pain, you will not stop the activity causing the injury.

Neuropathy may also interfere with bladder emptying, and result in recurrent or severe bladder/kidney infections.  Other organ effects may include heart rhythm irregularities, chronic diarrhoea or constipation and reflux.

What are some conventional treatments for diabetic neuropathy?

Medications include pain tablets, but if opioids are used chronically, there is a risk of addiction; tricyclic or more modern antidepressants; anticonvulsant drugs and topical creams/lotions.  Specific medications that help chronic neuropathic pain include Gabapentin and Lyrica – somewhat expensive and with troublesome side effects, especially if started on high doses too quickly.

Non-medical interventions include physiotherapy, electrical nerve stimulation and massage therapy.

What lifestyle interventions are available, and can they reverse diabetes?

In the standard main-line literature and recommendations from policy-makers and national organisations, there is very little mention of lifestyle factors – apart from the importance of exercise and a “prudent” diet.  But what is meant by a prudent diet?  This normally means a diet that is rich in fruits and vegetables and legumes, and low in refined foods.  But it normally includes fish and lean meats and so-called healthy fats.  The best that these interventions can hope for is reduction in symptoms and arrest of progression.

ALSO READ : Turning the Tide – Understanding Diabetes (part 6)

But what if I told you there is a way to totally reverse peripheral neuropathy in as little as 4-7 days in up to 75% of patients with diabetic neuropathy?  You would probably say that is far-fetched.

I encourage you to watch this video, and re-think this concept:

There is mounting research evidence that a plant-based whole food diet can not only prevent diabetes in the first place, but also in many cases correct complications such as peripheral neuropathy, even when patients have suffered these side-effect for years.

For those who are more scientifically orientated, or who really want to see scientific evidence for a recommendation of a whole-food plant-based diet, here is an excellent review article:

I may well use this article as the basis for next week’s discussion about how to manage diabetes from a truly lifestyle medicine perspective.  There is far too little emphasis of this option, and yet it gives rapid results with minimal expense and virtually no adverse side-effects.  But of course it is not favoured by Big Pharma, because it diminishes dependence upon medicines and medical interventions!

One huge concern is why health practitioners are not taking this information more seriously.  Most likely the answer is that they don’t know.  Here is where you as a patient can help to encourage your doctor to get on board, and at least offer you the option.  There is more than enough sound scientific backing to this approach.

To a week of rethinking conventional wisdom in managing diabetes.

Dave Glass

David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.

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