Amy Campbell is a registered dietitian and Certified Diabetes Educator who has been working in the field of diabetes for many years. She is the author of several books about diabetes, including 16 Myths of a Diabetic Diet and Staying Healthy with Diabetes: Nutrition and Meal Planning. In addition, Amy is a lecturer and frequent contributor to several diabetes-related websites.

Diabetic neuropathy, a common complication of diabetes, is nerve damage caused by diabetes. About 60 to 70 percent of people who have diabetes will likely develop some form of neuropathy; the risk goes up the longer one has diabetes. While the legs, feet, and hands are often affected, this complication can affect nearly every organ system in the body, including the digestive tract, the heart, the lungs, the eyes and the reproductive organs.

Causes of neuropathy

The primary cause of neuropathy is prolonged high blood glucose levels. But because there are different types of neuropathy, nerve damage can also be caused by other factors, such as:
• high blood lipid (fat) levels
• autoimmune factors that cause inflammation of the nerves
• mechanical injuries
• lifestyle factors, including smoking or use of alcohol

Symptoms of neuropathy

Some people who have neuropathy have no symptoms. But others will experience numbness, tingling or pain, usually in the feet. Other common symptoms include muscle wasting, indigestion, nausea, diarrhea, dizziness after standing or sitting up, trouble urinating, erectile dysfunction in men, and vaginal dryness in women.

Treatment of neuropathy

There’s no cure for neuropathy at this time. The main focus is bringing blood sugar levels under better control to help slow the progression of nerve damage. This is typically done with a combination of medication and lifestyle measures, including nutrition, physical activity, weight loss and smoking cessation.

How foods can help

Having neuropathy can be frustrating, painful, and frankly, scary. The good news, though, is that focusing on healthful food choices and overall good nutrition may help you prevent neuropathy (and other diabetes-related complications) or slow its progression. Here’s how:

1. Control your carbs. Having diabetes doesn’t mean you need to cut carbohydrate (carb) out of your diet, but it is important to pay attention to how much you eat at any one time. Controlling your carb intake makes it easier to keep your blood sugars in a safe range. Carbs are found in starchy foods, such as bread, pasta, rice and cereal; fruits and fruit juices; milk and yogurt; and sweets. Carb counting is a useful meal planning approach that lets you enjoy carb foods but in controlled amounts. Many people count grams or servings of carb at each meal and snack. The amount that you need can depend on factors such as your age, gender, weight and level of activity, so it’s best to meet with a dietitian to learn how much is right for you.

2. Aim for a healthy cholesterol level. Some studies indicate that blood cholesterol levels may be linked with neuropathy. A healthful diet based on vegetables, fruits, whole grains, lower-fat dairy foods, leaner protein foods (lean meat, chicken, fish) and heart-healthy fats (olive oil, canola oil, nuts and seeds) can help you get your cholesterol to a safe level.

3. Get enough vitamin B12. A lack of enough vitamin B12 can put you at risk for getting neuropathy and may worsen an existing type of neuropathy called peripheral neuropathy. People who take metformin for diabetes, vegetarians and older adults are at risk for B12 deficiency. Talk with your doctor about getting a blood test to check your B12 level and about taking a supplement. In the meantime, eat foods high in B12, including poultry, fish, lean meat, eggs and fortified cereals.

4. Try a vegan diet. Eating a plant-based diet may help with neuropathy pain. 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, weight loss, better A1C and cholesterol levels, and improved quality of life compared to the control group.

5. Limit alcohol. Drinking alcohol may worsen neuropathy symptoms like numbness and pain. In addition, drinking alcohol regularly may make it harder to control your blood sugars. Talk with your doctor about whether drinking alcohol is advisable for you.

6. Go gluten-free (maybe). There’s some evidence that celiac disease could cause neuropathy. The treatment for celiac disease is a gluten-free diet, which means avoiding foods that contain wheat, barley and rye. Celiac disease is also more common in people who have type 1 diabetes, as both are autoimmune conditions. However, before you cut gluten out of your diet, ask your doctor if you should get checked for celiac disease.

7. Consider supplements. A few dietary supplements could be helpful in easing neuropathy symptoms. Alpha lipoic acid is used frequently in Europe to treat neuropathy. Fish oil, evening primrose oil and curcumin (found in turmeric) are other supplements that might be helpful. Again, it’s wise to discuss the use of any kind of supplement with your doctor.

To learn more about neuropathy:

Supplements for Neuropathy
Relieving Diabetic Nerve Pain