Diabetes is a complex chronic condition that comes with a host of symptoms if not properly managed. One of the most complicated and challenging symptoms to treat is diabetic peripheral neuropathy. Also referred to a peripheral neuropathy or diabetic foot pain, this complicated condition requires thoughtful diagnosis and comprehensive treatment. What is peripheral neuropathy, and what does diabetic nerve pain feel like? Here’s what you need to know.

What is diabetic nerve pain, or diabetic neuropathy?

Neuropathy is an over-arching term that means nerve pain. There are four types of neuropathy, including:

• Peripheral neuropathy
• Autonomic neuropathy
• Radiculoplexus neuropathy
• Mononeuropathy

Peripheral neuropathy refers to nerve pain that is experienced on the periphery of your body, like the hands and feet. This area is enervated by the peripheral nervous system (instead of the central nervous system, which deals only with the brain and spinal cord).

There are many conditions that can result in nerve pain in the farthest reaches of the body, including:

• Vitamin deficiencies
• Alcoholism
• Autoimmune diseases
• Certain medications

The most common cause of peripheral neuropathy, though, is poorly controlled diabetes.

The hallmark of diabetes is a nearly constant fluctuation of the blood sugar, with spiky highs and cavernous lows. This constant fluctuation damages the capillary walls (small blood vessels) responsible for delivering blood to the nerves, especially in the hands and feet. As the capillaries become more damaged, diabetic neuropathy symptoms begin to appear.

What does diabetic nerve pain feel like?

So what does diabetic nerve pain feel like? There are many symptoms, including early onset symptoms that may be mild and challenging to diagnose. Diabetic neuropathy symptoms usually begin in the toes and work their way towards the head.

The first symptoms you may experience are tingling and numbness in the toes or fingers. This may resemble the feeling of “pins and needles” when a foot that has fallen asleep begins to wake up. You may also experience cramping in the feet, poor reflexes, and poor balance or coordination. Some people experience hypersensitivity and feel painful sensations with the slightest touch (even of the bedsheet grazing your toes at night).

In one of the few visual symptoms of diabetic peripheral neuropathy, a person may develop what is known as a hammertoe. This foot deformity causes the toes to begin to curl under and develops as a result of unconscious modification of the gait due to pain or other symptoms.

As the condition progresses, symptoms become more pronounced and more challenging to treat.

11 common diabetic neuropathy symptoms

Left untreated, diabetic neuropathy symptoms increase in intensity as the condition worsens. Wondering what does diabetic nerve pain feel like? Here are 11 symptoms to watch out for.

1. Increased numbness

This feeling can worsen to the point where a patient is unable to feel their feet as they walk. This becomes especially dangerous when feet lose all feeling.

The patient is then unable to tell if their feet have been injured or if the bathwater they are about to step into is too hot. Serious scalds, burns, and cuts can result from this numbness.

2. Burning in the feet

Diabetic foot pain is often accompanied by tingling and burning in the feet.

Ranging in intensity from barely perceptible to full-blown unbearable, this is the nerves’ way of communicating distress even further.

3. Sharp, shooting pain

This is the type of pain that can leave a person breathless. Almost like an electrical shock, this pain can occur without any particular stimulus or prompt.

4. Increased pain at night

Whether it’s because you are no longer distracted by the concerns of the day or the hypersensitivity and pain caused by even the sheet touching your feet, diabetic nerve pain is often much worse at night, making sleep impossible.

Because poor sleep and increased pain are bidirectional, one makes the other more intense in a cycle that is hard to break.

5. Slow-healing wounds

An adequate blood supply is important for good circulation that helps heal wounds.

For patients with peripheral neuropathy, even the slightest wound may be slow to heal (or may not fully heal).

6. Muscle weakness

As peripheral neuropathy progresses, muscle weakness may develop.

The peripheral nervous system is not just responsible for sensory information. Signals for movement and coordination are also delivered via these nerves. Nerves that are damaged rely on inadequate or incomplete information to the muscles and may result in poor coordination and weakness.

7. Gastrointestinal issues

Most people don’t think about the gastrointestinal system when considering peripheral neuropathy, located as it is in the center of the body.

However, as peripheral neuropathy continues to progress, this system can also be affected. Nausea, vomiting, diarrhea, and constipation can all occur.

8. Sexual dysfunction

Men with peripheral neuropathy may experience erectile dysfunction related to decreased blood flow and poor nerve signaling.

Women may experience increased vaginal dryness and a lack of desire.

9. Urinary tract infections

Men and women both may experience urinary tract infections.

The body may be overwhelmed with infections elsewhere in the body, and other gastrointestinal issues can lead to issues in the urinary tract as well.

10. Postural hypotension

Also known as orthostatic hypotension, this condition occurs when a person’s blood pressure drops dramatically, even when sitting, causing them to faint.

This can be potentially serious if it occurs while driving or even when simply standing up.

11. Amputation

Diabetes is responsible for approximately 70,000 amputations of the lower limbs annually in the U.S.

When feeling leaves the lower extremities and wounds or sores go undetected, they can become infected and even gangrenous. In these cases, amputation must be performed to prevent further damage or even death.

Can diabetic neuropathy go away?

Without treatment, diabetic neuropathy will not resolve itself and can, in extreme cases, lead to death from infection. It is crucial to get a proper diagnosis first and then proceed with treatment.

In the beginning stages of diagnosis, your doctor will conduct bloodwork and lab tests to rule out other potential causes of your symptoms.

Once your doctor eliminates other conditions, they may perform additional tests, including:

• Nerve conduction studies: Measures nerve response to electrical stimulation
• Electromyography (EMG): Measures electrical discharge from the nerves
• Filament tests: Looks for hypersensitivity that is the hallmark of peripheral neuropathy
• Quantitative sensory testing: Measures the nerve response to sensory changes including vibration and temperature

How to treat diabetic peripheral neuropathy

Once you have a diagnosis, there are many treatment options to ease symptoms and prevent worsening of nerve pain.

1. Manage diabetes

Since diabetic nerve pain is caused by poorly managed diabetes that causes damage to the blood vessels, the first thing to do is to get your blood sugar under control.

Talk to your doctor about changes to diet, exercise, and insulin administration that can help.

2. Keep an eye on your feet

Early warning signs occur most often in the feet. Check your feet daily for blisters, cracks, ingrown toenails, or wounds that are slow-healing or getting worse.

The American Diabetes Association recommends an annual foot exam, but daily foot checks are crucial for early detection and treatment. If you are unable to bend down to see the soles of your feet, use a mirror or ask a family member to help.

3. Practice proper foot care

In addition to daily checks, taking care of your feet can help improve health.

Daily foot massage improves circulation and feels relaxing at the end of a long day. Keep feet clean, dry, and moisturized to maintain skin health, too.

4. Stop smoking and limit or avoid consumption of alcohol

Health begins with what you put in your body. Tobacco products in any form inhibit the body’s healing response and narrow already challenged blood vessels. Alcohol has a similar effect on the immune system, dampening the body’s response to infection.

Some people are able to consume a daily glass of red wine or two, but talk to your doctor. In acute stages of infection, avoid alcohol.

5. Get active

The prime risk factor for both Type 1 and Type 2 diabetes is obesity. Extra weight places a huge burden on your joints and feet, which can make self-care challenging.

To combat this, exercise maintains a healthy weight, slows nerve damage, and naturally manages blood sugar, all of which can help alleviate symptoms of peripheral neuropathy.

6. Investigate medication

There are some medications that can assist in pain relief. Anticonvulsant drugs and tricyclic antidepressants, although not well understood in how they work on this condition, do seem to help relieve diabetic foot pain by changing the way the brain senses pain.

Tricyclic antidepressants include:

• Amitriptyline
• Clomipramine (Anafril)
• Desipramine (Norpramine)
• Doxepin
• Imipramine (Tofranil)
• Nortriptyline (Pamelor)

Finding the right medication may take some time, so be patient with this treatment approach.

Non-opioid pain relievers may also help for acute cases, but opioids are not generally recommended for peripheral neuropathy.

7. Use topical creams and supplements

Capsaicin is the compound found in spicy peppers that can provide topical pain relief.

Alpha-lipoic acid (ALA) is a supplement that may help lessen the advance of diabetic peripheral neuropathy.

8. Try physical therapy

Physical therapy exercises for diabetic peripheral neuropathy can help provide relief from tingling, burning, and pain in the feet. These exercises also improve muscle strength and physical coordination. They may also help with sexual dysfunction by improving blood flow and circulation.

For patients who have injured their feet by changing the way they walk, consciously or unconsciously, gait training is a type of physical therapy that helps people learn how to walk again. It is also used for people who have a prosthesis to help them walk properly so as not to transfer injury or pain to another part of the body (e.g., the hips).

Some physical therapy is combined with electrical nerve stimulation, which may help with stiffness in the feet and speed healing of ulcers or other wounds on the feet.

9. Manage other conditions

If you are experiencing gastrointestinal side effects including nausea, constipation, or diarrhea, managing these is important. Focusing on a supportive diet can help.

Similarly, it is important to treat urinary tract infections promptly, as increased nerve damage may result eventually in urine leakage.

For patients with sudden drops in blood pressure, compression stockings for the abdomen and legs can help, as can simply taking care when changing position.

10. Research advanced care

Other pain-relieving injections and therapies can help with more advanced cases, such as TENS unit therapy or nerve blocks.

This complex condition also remains the focus of much research and study. For example, a recent non-viral gene therapy study offered promising results in the dramatic pain relief of diabetic peripheral neuropathy with low doses of medication, well into a year after the treatments.

Diabetic peripheral neuropathy is a challenging condition that needs a comprehensive approach to treatment. If you are experiencing this side effect of diabetes or another pain condition, give Arizona Pain a call today. We can help.

Diabetes is a world-wide health issue. It can lead to a host of conditions, including diabetic nerve pain. Here’s what you should know about diabetes, how to avoid your own diabetes risk factors, and reduce your chances of future pain.

What is diabetes? 

Sugar is a compound found in many foods nowadays that can cause extreme problems for diabetics. The human body processes glucose, or blood sugar, and converts it to energy. Glucose is found in many natural food sources and makes things sweet such as fruit or desserts. It is also a product of starchy carbohydrates such as potatoes and pasta. Glucose is regulated in the body by insulin, a hormone produced by the pancreas. It stimulates cells to process glucose and turn it into the right amount of energy needed to function daily.

Healthy insulin levels should rise and fall according to the amount of glucose in the body. When eating, glucose levels rise as should insulin. When blood sugar drops, natural insulin should also drop.

Diabetes is an incurable disease caused when the body does not produce insulin in the correct way. The body is then unable to process blood sugar naturally which can lead to medical emergencies resulting from extreme highs and lows of glucose in the system.

Some statistics about diabetes include:

• In 2015, 30.3 million people in the U.S. (or 9.4% of the population) had diabetes
• China has the most diagnosed cases of diabetes, with 98.4 million cases in people between the ages of 20 and 79.
• There were 382 million people globally living with diabetes in 2013. That number is projected to rise to 592 million people by the year 2035, an increase of 55%.
• North America will spend 263 billion annually on health costs related to diabetes. Diabetes is the 7th leading cause of death in the U.S.

Diabetes symptoms

Worldwide, 46% of diabetes cases go undiagnosed, so it is important to raise awareness and recognize the signs and symptoms of this disease. For Type 1 diabetes, symptoms usually come on swiftly and are extreme, while Type 2 symptoms may occur gradually over time.

Some diabetes symptoms to watch out for include:

• Excessive thirst and frequent urination
• Extreme fatigue
• Blurry vision
• Numbness or tingling in the extremities (hands and feet)
• Increased infections
• Wounds that heal more slowly than usual
• Weight loss not associated with a change in diet
• Increased appetite
• Difficulty staying focused
• Loss of interest
• In severe cases, nerve pain

Types of diabetes

There are two common forms of diabetes, type 1 and type 2. There is also a form known as gestational diabetes. This type of diabetes occurs in approximately one in 25 pregnancies across the globe. Although generally resolved post-partum, women who experience gestational diabetes are more prone to developing Type 2 diabetes later in life, as are their children.

Type 1 diabetes

Also known as juvenile diabetes, this is an autoimmune disorder where the body attacks the healthy cells of the pancreas and essentially shuts down the body’s natural production of insulin. Most people are diagnosed with this condition before the age of 40, although in rare cases it may occur later in life. The exact cause is uncertain but genetics plays a significant role in the disease. It is also possible that exposure to certain viruses can cause the onset of the disorder.

Since the disease is most likely to occur in children it is important for parents to watch out for the signs. Symptoms can include:

• Excessive thirstiness
• Frequent urination
• Bed wetting for children without a history of it
• Unexpected weight loss
• Mood swings
• Blurred vision
• Fatigue
• Weakness

However, it is also important to note that none of these experiences are unique to diabetes, so there may be a variety of potential causes. If you notice these symptoms in your child you may wish to consult a doctor for an accurate diagnosis.

Since type 1 diabetes is an autoimmune disorder, there isn’t much that can be done to prevent it from occurring, and diabetes risk factors are harder to control. Family history plays a role and individuals with parents or siblings with the disease have an increased risk.

Type 2 diabetes

Frequently called adult-onset diabetes, this is a chronic condition that affects how the body metabolizes sugar and produces insulin. When we talk controlling diabetes risk factors, this is typically the type of diabetes we’re referring to.

For type 1 diabetics the body may continue to produce insulin but still not process sugar correctly or the pancreas might not be making the right amounts of insulin to properly metabolize the glucose. Type 2 diabetes mainly affects adults, although childhood obesity rates are increasing the cases in younger people. The condition is incurable but can be managed in most cases by maintaining a healthy lifestyle although some people still need to take insulin.

Type 2 diabetes develops slowly and many people have the condition for years without knowing it. Excessive thirst and hunger may be symptoms of the condition along with frequent urination, slow healing infections, and patches of darkened skin which may be a sign of insulin resistance. Genetics may be a cause of type 2 diabetes, but it is most prevalent in individuals with unhealthy habits including obesity and inactivity.

What are the major diabetes risk factors?

Diabetes risk factors are different for different people. Although heredity plays a large part in Type 1 diabetes, there are other risks factors for Type 2, some of which can be controlled.

Major diabetes risk factors

The major diabetes risk factors include:

1. Lack of physical activity. People who are inactive and do not get a minimum amount of physical exercise daily are at an increased risk. Sedentary lifestyles also contribute to other risk factors such as drinking and smoking, which, in combination, increase the risk of diabetes exponentially
2. Unhealthy diet. Diets high in fat, sugar, and processed foods increase the chances of developing diabetes.
3. Obesity. Obesity is the number one risk factor for developing diabetes. With a few notable exceptions, people who are obese tend to have a lower level of physical activity and an unhealthy diet. A higher BMI generally indicates a higher risk
4. Age. The older you are, the more likely you are to develop Type 2 diabetes.
5. High blood pressure. High blood pressure can be caused by a number of different conditions, which can then lead to diabetes.
6. Race and socio-economic status: People of Southeast Asian, Middle Eastern, African, and Latino descent have a higher incidence of diabetes than their caucasian counterparts. Low-income minorities are more at risk for diabetes for all of the above reasons but also due to limited access to fresh food, medical resources, and education

These are the major risk factors that we have a lot of research behind. While some risk factors for diabetes are not within a person’s control, scientists are always studying what other actions people can take to reduce their chance of having diabetes. Four recent risk factors have come to light.

1. Watching TV

What is the easiest way to increase your risk for diabetes? Spend more time in front of the television.

A new study published in Diabetologia found that every hour spent watching television increases the risk of developing diabetes by 3.4%. This result was part of a Diabetes Prevention Program (DPP) lifestyle intervention that was looking at how increasing physical activity helped prevent or treat diabetes. Researchers were not expecting to find that TV watching itself was a substantial lifestyle risk factor.

2. Low vitamin D levels

A new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism found that even more than obesity, low vitamin D levels indicated an increased risk for developing diabetes. Considering that over one billion people worldwide may have low levels of vitamin D, this is a troubling finding.

One of the study’s authors, Mercedes Clemente-Postigo, MSc, of Instituto de Investigación Biomédica de Málaga (IBIMA) at Complejo Hospitalario de Málaga (Virgen de la Victoria) and Universidad de Málaga in Malaga, Spain, noted that the strength of the study was its variety of participants, saying:

“The major strength of this study is that it compares vitamin D levels in people at a wide range of weights (from lean to morbidly obese subjects) while taking whether they had diabetes into account.”

Another of the study’s authors, Manuel Macías-González, PhD, of Complejo Hospitalario de Málaga (Virgen de la Victoria) and the University of Málaga, proposed that even if the findings were troubling, the solution may be simple, saying:

“Our findings indicate that vitamin D is associated more closely with glucose metabolism than obesity. The study suggests that vitamin D deficiency and obesity interact synergistically to heighten the risk of diabetes and other metabolic disorders. The average person may be able to reduce their risk by maintaining a healthy diet and getting enough outdoor activity.”

3. Fat choices

Diet is a primary treatment protocol for both Type 1 and Type 2 diabetes. Most treatment plans recommend low-fat dairy products, presumably to help manage weight gain and BMI, but new research from Lund University shows that full-fat dairy products are the best choice when it comes to reducing the risk of Type 2 diabetes. It appears that it is not necessarily the level of fat in the diet that increases risk, but rather the type of fat. While consuming full-fat dairy products reduced the risk of developing Type 2 diabetes, meat consumption increased the risk.

Study author Ulrika Ericson noted that the composition of fat in foods may be the key to why some fat appears to lower risk while other fat raises it:

“When we investigated the consumption of saturated fatty acids that are slightly more common in dairy products than in meat, we observed a link with a reduced risk of type 2 diabetes. However, we have not ruled out the possibility that other components of dairy products such as yoghurt and cheese may have contributed to our results. We have taken into account many dietary and lifestyle factors in our analysis, such as fermentation, calcium, vitamin D and physical activity. Our results suggest that we should not focus solely on fat, but rather consider what foods we eat. Many foodstuffs contain different components that are harmful or beneficial to health, and it is the overall balance that is important.”

4. Less added sugar

The number of people with Type 2 diabetes worldwide has more than doubled from 153 million in 1980 to 347 million in 2008. One of the reasons for this increase may be the increased consumption of fructose. Current nutritional guidelines indicate that a diet can have up to 25% of added sugars daily, but researchers have called for a drastic reduction of that in a recent write-up in Mayo Clinic Proceedings.

Lead author James J. DiNicolantonio, PharmD, a cardiovascular research scientist at Saint Luke’s Mid America Heart Institute in Kansas City, Missouri, plainly stated the causes and consequences of this increased consumption, saying:

“At current levels, added-sugar consumption, and added-fructose consumption in particular, are fueling a worsening epidemic of type 2 diabetes. Approximately 40% of U.S. adults already have some degree of insulin resistance with projections that nearly the same percentage will eventually develop frank diabetes.”

Recommendations for appropriate levels of added daily sugar consumption vary widely and include the following:

• 2010 Dietary Guidelines for Americans: 19%
• Institute of Medicine: 25%
• World Health Organization: 10% (with a goal of 5% for “optimal health”)
• American Heart Association: No more than six teaspoons for women and nine for men

Fructose naturally occurs in fruit, which is fine to consume and does not count towards a daily total of added sugars. This study specifically looked at processed foods with added sugar (e.g., spaghetti sauce, salad dressing, cereals, etc.). The study authors believe that dietary guidelines should be further edited to include more consumption of fruits and vegetables, a lifestyle change that can prevent Type 2 diabetes.

How to prevent diabetes

Type 1 diabetes cannot be prevented at this time, but Type 2 diabetes can be prevented or the progression of the disease slowed if corrective action is taken.

To reduce your diabetes risk factors and chances of developing diabetes, follow these simple guidelines.

Reduce your sitting time

Getting up and moving around every 20 minutes or so increases blood flow to the brain and muscles and generally improves circulation. Simply stretching at your desk or walking around during commercial breaks when watching TV can reverse the effects of too much sitting.

Increase exercise

It doesn’t matter where you start an exercise plan as long as you start one. Walking for one hour three times a week can reduce the progression of diabetes by up to 58%, and 30 minutes of any type of daily exercise (walking, biking, swimming, etc.) reduces the risk of developing Type 2 diabetes by 40%. Start an exercise plan by walking five minutes a day, even if that is all you can do, and gradually add on to that until you are walking for at least 30 minutes daily.

Fix your diet

Malnutrition or inadequate food sources are a problem that is at the root of diabetes around the world. Some blame urbanization and the accompanying food deserts that exist in city environments for the shabby state of nutrition in city dwellers. In some cases, it may be possible to remedy this with CSA (community-supported agriculture) deliveries. In others, it may be harder to remedy than simply telling people to eat better.

Whatever the case may be, adding as many fresh fruits and vegetable to your diet, along with whole grains and lean proteins is a step in the right direction. Eliminate sugar and processed foods as much as possibly and substitute in healthy snacks and meals when possible. Global poverty, regional conflicts, and food shortages due to weather make this step more difficult for some areas of the world, but it is a necessary change to help curb diabetes.

Get enough sleep, but not too much

Sleeping less than six hours a night or more than nine hours can increase your chances of Type 2 diabetes. Sleeping less interferes with the way the body processes food, and sleeping more can indicate depression, another risk factor for diabetes. Develop good sleeping habits and stick with them.

Stop smoking

In addition to increasing your cardiovascular healthy instantly, stopping smoking is an excellent way to reduce your risk of developing diabetes. Smoking is associated with weight gain in the abdomen and high blood pressure, both of which are risk factors for Type 2 diabetes.

To find out your risk for developing Type 2 diabetes, fill out this quick questionnaire.

Amid national concern about rising rates of diabetes and obesity, which often coincides with Type 2 diabetes, one population stands out as facing an exceptional risk: Native Americans.

Native Americans face more than double the risk of receiving a diagnosis of Type 2 diabetes than Caucasians. Type 2 diabetes is a disease marked by high levels of blood sugar, created by the body’s difficulty processing the hormone insulin. Complications include nerve damage and pain known as neuropathy, as well as eye and skin problems.

The diabetes epidemic is especially challenging in Arizona, where Native Americans face the highest recorded rates of diabetes in the world, according to the Society for Public Health Education (SOPHE). Even outside of Arizona, rates remain high, and Native Americans have the highest rates of diabetes among all other ethnic groups in the U.S.

November is Native American Heritage Month, making it a good time to discuss the health risks faced by indigenous communities. Native American Heritage Month is an initiative designed to celebrate indigenous cultures, but also intended to raise awareness about pressing issues modern tribal citizens face. In a community that navigates innumerable challenges, the diabetes epidemic is one of the most serious.

Native Americans face some of the highest rates of diabetes in the world.

The risks of diabetes faced by Arizona’s Native Americans are 245% higher than average, reports SOPHE. Not only are these groups more likely to develop diabetes, but they’re also almost twice as likely to die from it than others in the general U.S. population.

Rates of diabetes among indigenous communities have risen over the past few decades. From 1994 to 2004, rates of diabetes among Native Americans youths, including native tribes from Alaska, has increased by 68%, according to the American Diabetes Association (ADA). That’s among teens aged from 15 to 19. Type 2 diabetes is most common to develop in tribal members; Type 1 is relatively rare.

In addition to these already startling numbers, about 30% of Native Americans have pre-diabetes, which means they have higher-than-average blood sugar levels that do not yet fall into the range for diabetes.

Native Americans face problems including high rates of poverty, obesity, and alcoholism that increase risk and complications of diabetes.

Diabetes is the fourth leading cause of death in Native communities, according to the Centers for Disease Control and Prevention (CDC). The rates of diabetes have skyrocketed as nutritional habits in the communities have changed in favor of processed foods and people get less physical activity, according to a report from the National Institute of Diabetes and Digestive and Kidney Diseases.

High rates of poverty also make it difficult for many people to pay for high-quality, nutritious food. The median household income for Native Americans is $37,353 compared to a $56,565 in Caucasian households, according to the Office of Minority Health.

One Native American charity reported visiting four Navajo elders to drop off fresh fruits and vegetables, whole grains, and white meats in hopes of convincing them to add some new, fresh foods into their diets. However, the elders were surviving on $400 to $650 each month, making it difficult to pay for healthy food. Their bodies were also weak from diabetes, making it difficult to start a new exercise program.

Public health initiatives reach out in an effort to improve the health of Native Americans.

Several Arizona initiatives have been developed to target high rates of diabetes, reports SOPHE. The Ajo Diabetes Outreach and Education Program, for instance, was organized to improve residents’ health in the form of outreach programs.

Some education initiatives were designed to teach patients how to better manage the condition, but others were targeted to reduce the risk among patients’ family members. Diabetes tends to be hereditary, but is often preventable through proper diet and exercise.

Another public health initiative took place on the Tohono O’odham tribe. The Food, Fitness and Wellness Initiative Project focused on disease prevention through increasing access to healthy food. As part of the program, students on the reservation were served meals cooked with the traditional food tepary beans. The efforts were successful and soon students were voting in favor of tepary beans over other foods, even pizza.

On a statewide level, the Arizona Diabetes Program works to implement prevention initiatives and treatment efforts to improve the lives of those already living with diabetes.

Nationally, the U.S. Department of Health and Human Services’ Indian Health Service has a special Division of Diabetes Treatment and Prevention (DDTP). The division works with local health service departments, providing information and training, and it administers a $150 million annual grant program known as the Special Diabetes Program (SDP). The grant money pays for various programs that are designed to make an impact on tribal citizens’ health.

The division also works with ADA to implement SDP initiatives. ADA works with tribal members, helping them to become politically active and ensure the funding remains in place. Native Americans are encouraged to tell their stories of how fear and suffering turned into hope and health as a result of outreach efforts and lifestyle changes.

ADA and DDTP also work together on a culturally sensitive program called Awakening the Spirit. Awakening the Spirit works with communities to encourage healthy food choices and more physical activity. The website says:

“Years ago, Native Americans did not have diabetes. Elders can recall times when people hunted and gathered food for simple meals. People walked a lot. Now, in some Native communities, one in two adults has diabetes.”

That stark reality inspires many who work to reduce the rates and help tribal citizens regain their health. An Awakening the Spirit subcommittee is made up of tribal members from across the nation. The group’s intention is to join forces and spread the message that taking care of the body is a spiritual imperative, and that those positive lifestyle choices reverberate throughout the community, improving lives for all.

Are you a Native American who has experienced the impact of diabetes? Tell your story.

Image by Adam Jones via Flickr

People with neuropathy looking for relief may want to try a vegan diet, according to a study completed by doctors with the Physicians Committee for Responsible Medicine (PCRM).

Vegan diets not only exclude meat, they are also devoid of eggs, cheese, chocolate, and other foods containing animal byproducts such as milk. Unhealthy vegan diets do abound—doughnuts and French fries cooked in vegetable oil technically follow the rules—but eating a balanced vegan diet rich in vegetables and fruits could help reduce pain from neuropathy, the study found.

People with neuropathy benefit from meat-free diet, study says.

Keep in mind that strict vegan diets are separate from vegetarian diets, which typically include eggs, milk, and cheese. However, both vegan and vegetarian diets have been found to be helpful for people with neuropathy.

Neuropathy involves nerve pain that may develop as a consequence of an underlying condition, including diabetes. About 50% of people with diabetes have the condition, and unfortunately effective treatment is extremely limited. Existing treatments only attempt to mitigate pain and aren’t able to offer a cure.

To uncover the benefits of a vegan diet on diabetic neuropathy, PCRM doctors assigned two groups with a total of 15 patients to a meatless diet low in fat and high in fiber. Diets included at least 40 grams of fiber each day and no more than 30 grams of fat, even if the fat came from healthy oils or nuts.

The foods also had to have a low glycemic index, which means they don’t lead to spikes in blood sugar. Examples of low glycemic foods include barley, grapefruit, and chickpeas, according to Harvard Medical School.

One group of study subjects received B12 supplements, and the other did not. In the groups, patients were a mean age of 57, and males and females were equally represented.

Transitioning to a vegan diet often requires support, and so the patients were required to attend weekly classes over the course of 20 weeks where they learned about nutrition and watched cooking demonstrations. They also sampled healthy vegan cuisine and connected with others living on a vegan diet.

Social support and learning new recipes helps people stick to a vegan diet.

The results showed strong support for the vegan diet’s potential for managing neuropathic pain, particularly those patients who took B12 supplements.

Researchers plan to continue studying the patients for one year to examine the long-term health effects of meat-free eating and its impact on neuropathy.

The PRMC research came on the heels of an earlier study conducted by doctors at California’s Weimar Institute. Scientists found that 81% of patients who abstained from meat experienced dramatic pain relief from neuropathy in as little as four days. Patients also lost on average 11 pounds.

Most patients in the study were also able to reduce the amount of medicine for diabetes and blood pressure they were taking. Patients’ cholesterol levels also dropped.

After four years, 71% of 17 patients studied continued to eat a vegan diet, and most experienced lasting relief from neuropathic pain. Researchers attributed the improvement to the meat-free diet, and not the better controlled glucose levels that also occurred.

Following a vegan diet can have wonderful health benefits, but risks include not ingesting the proper amount of required nutrients.

The American Dietetic Association (ADA) says “appropriately planned” vegan or vegetarian diets can provide health benefits or even prevent certain diseases.

Benefits of eating a meat-free diet, according to the ADA, include:

• Lower cholesterol
• Decreased risk of heart disease
• Lower blood pressure
• Lower risk of type 2 diabetes
• Lower risk of cancer
• Healthier weight

The key, according to ADA, is making sure that vegan or vegetarian diets are low in saturated fat and cholesterol while staying high in fiber and vital nutrients such as magnesium and potassium. Risks of eating a meat-free diet include lower levels of vitamins B12 and D, calcium, zinc, and omega 3 fatty acids, found in fish, which help protect the heart in addition to offering benefits for those experiencing neuropathy.

A potential B12 deficiency is especially important for those with neuropathy to stay aware of since deficiencies have been identified as a cause of the condition. The vitamin is integral to basic bodily functions, such as making DNA and red blood cells. Taking supplements or eating fortified foods is the best way for vegans to avoid deficiencies.

Soy or rice milk comes in B12 fortified options, as do some health food formulas developed specifically to meet vegan and vegetarian nutritional needs. Vegetarians can eat eggs, yogurt, or other dairy products to meet intake requirements of B12.

Fortified foods also help vegans take in enough calcium. An Oxford study cited by ADA found vegans were at a 30% greater risk of fracturing a bone, possibly because of lower calcium levels. To ingest enough calcium, some vegans take supplements or eat calcium-fortified foods, such as soy milk. Plants high in calcium include kale, bok choy, broccoli, and collard greens. Dried figs and sunflower seeds are also high in the important mineral.

Eating enough protein is another factor to consider during meal planning for vegans or vegetarians. However, the ADA says plant-based diets can provide enough protein for even athletes.

Protein from soy products, including tofu, is as effective at meeting the body’s requirements as animal products, according to ADA, although people eating protein solely from vegetables and grains may need to increase their daily intake to meet recommended levels.

No. 1 tip for a healthy meat-free diet? Mix it up. Eat a variety of fruits, vegetables, and grains.

If you’re looking to try a vegan diet, but are nervous to try, start small. Consider declaring one day each week meat-free. Knowing which foods to eat is also half the battle. Consider investing 30 minutes on a weekend and researching new recipes or buying a vegan cookbook.

Vegan meals can be tasty, healthy, and affordable. By using hearty foods like beans and experimenting with fun, colorful vegetables, your dinner plate will never be the same.

And hopefully, the diet will help you reduce pain from neuropathy.

Have you ever tried a vegan diet?

Image by Sonny Abesamis via Flickr