Long term LC and diabetic neuropathy?
 

Hello folks, this thread was recommended as a possibility for answering a question I have.

Has anyone noticed after say a few years of low carbing an impact one way or another on diabetic peripheral neuropathy (of any other type of diabetic neuropathy)?

Quick summary of my situation. 2 and 1/2 years ago diagnosed with T2 diabetes. A1c at 12.1, glucose at 400 in the office. Weight 283 (I'm six, six). Age 62.

Immediately to low carbs. NO medication of any type. (doctor thought I was crazy). Ten days later blood sugar normal (100). 12 weeks later all lipids near perfect and no damage to the body (so far as I know) except peripherial neuropathy in the feet. Numbness and no pain. Diagnosed as mild. A1c fallen to 5.1. Weight already down to about 250 by then.

So far so good for 2 and 1/2 years with low carbing. Weight steady at 197-8. (I weighed that when I was 18!) Running 15 to 20 miles a week. Feel great. Love my food too. No more than 30-40g a day and I run about a nine minute pace almost everyday. Evergy great. Body metabolizing fat beautifully. No craving for carbs at all.

But here is the issue. Still have the peripheral neuropathy. It is improved. But still there.

Has anyone experienced an impact of LC on such neuropathies one way or another? Or has anyone read anything from Dr. B or Atkins about the long term impact of LC on general health as well as specific conditions like the one I mentioned? Please understand I'm not talking about how to maintain the diet long term! I'm talking about the actual impact of LC on our bodies long term.

I am thinking that Dr. B or Atkins after all these years of observing such things would have some idea of how LC has impacted people with diabetes on a long term basis. Strange one never sees any data, even "anecdotal" pertaining to this. At least I haven't seen it. We already know that low carbs can handle blood sugar in a very short time for instance. I am the living proof of that. Surely they have such data as that for diabetics who have been low carbing for 5 to 10 years.

Would it not be interesting to know how LC helps a diabetic after say 5 or 10 years? Especially a diabetic who has never been medicated for diabetes but who has followed the LC way of life. What is the impact on specific things like lipids and such. Impact on disorders associated with diabetes.

Hope someone can lead me to some data.

Thanks, Brad

Hi Brad!

You might find some of the articles in these links to be helpful: http://www.diabetes-normalsugars.co.../articles.shtml
http://www.diabetes-normalsugars.com/readit.shtml

:)

Interesting question, Brad. Have you read Dr. Bernstein's book? His own personal experience certainly supports his theory that his methods work for the long term. He has been managing his own type 1 diabetes for many years (I believe he was in his early 30s when he began and is now in his early or mid 70s.) I'm at work and don't have my book with me, so I can't check on his actual stats, such as A1C, blood lipid levels, blood pressure, etc., but they're all listed in the book and are all considerably better than normal.

Your question reminds me of a question that I've had for a long time, though - why has there not been research done into the long-term effectiveness of a low carb diet for diabetics compared with the standard "diabetic diet"? Or a broader study comparing the long-term complications of the various methods of managing diabetes? I simply can't understand why this hasn't been done many years ago. It would be a relatively easy thing to do compared with the complexities of many studies that have been done over the years. It almost makes my paranoid mind wonder whether certain powerful groups (pharmaceutical companies and groups whose research they sponsor) are opposing it for reasons of their own. Well, pardon my rant for the day!

Karen

Hello Karen! I basically skimmed Dr. B's book. Frankly, I don't remember seeing any such data. Of course his personal observations are very important. And coming from him extremely important even though he is a T1.

But still as you go on to say and I have asked about we need those broader studies made available. You see, I actually think Atkins himself has such data. He and his group has been at this 30 years and they often claim the benefits of LC for diatetics. But where is the data or any kind after 10 years? It would be that "anecdotal" type of data that he is sometimes faulted for since it is his own data and not properly and scientifically acquired. But Karen, that would still suit me since I am a believer in LC to start with. I just want to know what people like Atkins have observed over the long haul. I see no need to wait for the properly conducted scientific study. Though that would be nice.

Now I don't want to upset you as I have perhaps a few already but I fault the great Dr. Atkins for not giving us a glimpse of the long term impact of LC on say something like our health in general and more specifically how it impacts diabetes and its disorders. Even if such data is anecdotal. As I say it would be could enough for me since I am a believer in the benefits of LC. You see, he constantly gives us data for the "short term" you might say. How it benefits our lipids and so on. But you know he has seen hundreds if not thousands of cases that stretch into 5 or 10 years or even longer.

In my opinion, the reason he emphasized the "short term" benefits and not the long term is that he was presenting a "diet" as a competitor among many diets and so he concentrated on the short terms benefits. After all, most people diet for only a short term. The long term way of life that is indicated by low carbing is not something that sells like the short term diet that can "lose you 10 pounds in one week." We know that story. I don't blame him for selling it this way. After all diet plans are profitable. But I just wish he had filled this story out the same way for the long term benefits. And I am assuming they are there! I just want to know what he found himself along that line. In other words, I wish besides extolling the merits of LC for short term gain he had also done more to show us the benefits of LC as a way of life which I think it is especially if you are like me controlling a disease.

So Karen you are probably right when it comes to the more scientifically controlled experiements. Such studies certainly wouldn't be in the interest of pharmceutical companies that make a mint off selling drugs to millions of diabetics. But Karen I think you have to be fair here. The blame really goes to the diabetics themselves who want their cake and eat it too. Don't you agree? My endo has over 20,000 diabetic patients. I am the only one who controls the disease with low carbing. He claims and we know he is right that all the diabetic wants is the magic pill that P&G is working on now. Almost all diabetics are fat with high blood sugar. They await the magic pill. Meanwhile they eat cake. And even in the last resort when a gallon of insulin won't bring down their blood sugar they still are reluctant to get serious and save their lives by LC. Isn't that the sad truth?

Karen, one last thing. Too wordy here I know. Since I'm looking for some info in the direction of how LC can help diabetic neuropathies you can see why I am a little irked that Atkins and others haven't made even their anecdotal observations about this known. Of course, it could turn out there is no positive impact of LC on neuropathies like mine. Or negative either in which case it wouldn't matter. But still it would be nice to know, as you say, the long term impact of LC on diabetes and the many dimensions of this disease.

I think your rant is necessary! Honestly though I think it has to be directed in a few more directions. Thanks, Brad

Thanks, Lisa, I will be checking that out. In fact have already started. So far not much help. I keep thinking it is around the corner. Brad.

Good question! The cynical side of me thinks that using a method of eating that effectively controls diabetes in many type 2 diabetics wouldn't be too good for business for the pharmaceutical companies.
As for why hasn't low carb been used to treat diabetics...it has! My dad is a retired doctor (still kickin' at nearly 92) and tells me that when he was beginning his medical practice, the diet of choice for diabetics was low carb. Of course, it was also low fat (a detail that we still don't see eye to eye on, but he can't argue with my results after 3+ years). It was only with the advent of reliable insulin and oral medications that the diets for diabetics started changing to allow for more carbohydrate intake to where we have the ADA today telling diabetics that it's perfectly okay to eat sugar "as long as they cover it with additional medication". :rolleyes:

Hi again, Lisa! I can imagine the battles you waged over the "low fat" issue. You of course discovered how hard it is to overcome the standard views.

But Lisa, again, can I stress it is not just a matter of controlling the diabetes in the sense of controlling such things as blood sugar. Of course, that is important and people have actually known for a long time that diet impacts blood sugar. What in addition I am trying to get at is the long-term impact of LC on a wide variety of factors. Say for example our lipids after 10 years. Atkins already knew of the importance of such things as the "bad" form of LDL. This is something that the NMR Lipid Profile test can show. He argues that if you go LC you help this LDL profile improve. But as far as I know he didn't say much if anything about this 10 years into low carbing.

Or what interests me, the diabetic neuropathies. As far as I know he doesn't say anything about the LC impact on that. I do remember him urging us to try Alpha Lipoic Acid. But what did he observe 10 or so years later on the neuropathies, if anything. Did he notice his diabetic patients getting better or worse or did they stay the same (in regard to neuropathies) compared to other ways of treating diabetes?

You know he and others with him observed such things over the 30 or so years of their important work. I just wish he had filled us in with this. I explained above in a post to Karen some of the reasons I think this is missing from Atkins' account.

As I mentioned to Karen the drug companies don't have to worry about losing diabetic customers to low carbing. Most diabetics want their cake and eat it too. That is the sad simple truth. The magic pill, they think, is on the way that will allow them to do that and not die so early.

Can you imagine those patients your dad mentioned contolling their blood sugar with low carbs and low fats! What a life! I know a few vegans who have gotten themselves into that difficult situation having finally recognized that carbs contribute to fat! How hilarious if not so tragic! Brad

Brad, I don't think that Dr. Atkins ever specifically spoke to those issues, possibly because his specialty was cardiology and I don't believe that he used his own patients' records to follow progress at 10 years out, espcially given that paper records can take up quite a bit of space and legally doctors are only required to keep records for the past 7 years. I have heard, though, that there is a book coming out this fall written, at least in part, by Dr. Atkins on the subject of diabetes or diabesity as he referred to it and perhaps some of the questions that you have are addressed in the new book.
However...Dr. Richard Bernstein (the site that I gave the links to) has spoken to at least some of those issues. His own cardiac profile, even as a type 1 diabetic is picture perfect after more than 3 decades as a low carber.
His own story is that he has managed to reverse quite a few diabetic complications (I believe that neuropathy was one of them), including early kidney damage, with a low carb approach.
I will say, though, that if a neuropathy is to reverse itself with a low carb approach, it will likely take some time. Peripheral nerves can and do regenerate, but it is a slow process. When I was young, I severed a nerve in my left foot by stepping on a sea wall spike (all the way through the foot) causing numbness to my last 3 toes and part of the distal foot. It did regenerate over the period of a few years, but the process was...uncomfortable.

Hi again, Brad,

I think that if you've only "browsed" Dr. Bernstein's book Dr. Bernstein's Diabetes Solutions, it's time you sat down and read it cover to cover. I'm going to quote the first couple of paragraphs of the preface:

In 1946 I developed diabetes. According to current statistics, I should have been dead years ago, but today I'm in excellent health, routinely work twelve or more hours a day, and have outlived all but a handful of people who developed diabetes when I did.

Twenty-seven years ago, I had already suffered many of the disorders long associated with diabetes, and even my doctor, who was president of the American Diabetes Association, could do nothing to slow their advance. Today the progression of those complications has long been stopped, and some of them have reversed. I'm healthier now than I was then...

If you read the next section, My First Fifty Years as a Diabetic," he goes on to say that a number of complications he had developed were reversed: After years of chronic fatigue and debilitating complications, almost overnight I was no longer continually tired or "washed out." After years of sky-high readings, my serum cholesterol and triglyceride levels had now only only dropped, but were at the low end of the normal ranges.

He goes on to say how his insulin requirements dropped to one-fifth of his original dosage, his digestive problems cleared up, and the proteinuria that had been severe enough to cause him considerable worry vanished to the point that today, even the most sensitive kidney function tests are all normal.

You should also read the next section entitled: Before and After: Fourteen Patients Share Their Experiences. Here many of his long-term patients tell their stories of the improvements they have seen since adopting Dr. Bernstein's methods.

One more reference - Chapter 23 is called What you Can Expect from Virtually Normal Blood Sugars and it goes into some of the postive changes that he has seen in both himself and his patients over both the short and the long term.

So, if you read the book, I think you'll find a lot of the information you've been looking for, perhaps not in quite the scientific form you would have liked, but certainly from a very credible source.

Karen

One more thing I forgot to mention, Brad, is to ask if you are aware that the book Dr. Atkins had almost completed when he died is coming out in August. It's his only book written specifically for diabetics, so perhaps it will have some of the information you're hoping to find. It's called Atkins Diabetes Revolution: The Groundbreaking Approach to Preventing and Controlling Type 2 Diabetes, and I have pre-ordered it from the Amazon website. In my case, I want to read it just as a matter of interest. Dr. Bernstein's methods work so well for me that I have no interest in changing anything - why tamper with success? - but, as you have been following Atkins rather than Bernstein, you may find it of particular interest.

Karen

Thanks, Karen, look forward to seeing what Atkins has in this new book. It is true that I only browsed Dr. B's book because I felt that at bottom there are vital differences between T1 and 2. Even then I do recall some of the things you mentioned as being helpful. And now that you have brought my attention back to that I will check those references again. And no, I don't require "scientific" data. I even prefer the "anecdotal" data of a man like Dr. B but wish with all his experience a little broader sampling on the long term impact of LC could be commented on. Which is what I was wishing Atkins had done. Still Dr B's observations about himself are important which is why I orignally asked if anyone here had personal experience with some of the things I was asking about. Though as I say I am looking more to the expereiences of the T2.

Maybe Atkins will really focus on this issue and tell us more about the long term impact of LC on the T2. Brad

Dr. Bernstein's book is intended every bit as much for type 2s as type 1s. I'm a type 2 who has been following his advice for the past two years with great success, which is why I'm coming across as a bit of a fanatic when it comes to him. My last A1C was 5.2, but I had earlier ones of 4.7 and 4.8. I attribute the 5.2 to the fact that I started eating sugar-free peanut butter, which I have had to admit is a no-no for me. My daily readings have been down again since I cut it out, and I'm fully expecting my next A1C to be back under 5. My blood lipids are extremely good, my blood pressure has improved to better than normal, and I have far more energy than I've had for many years. And the neuropathy in my feet, like yours, has greatly improved; for a while I thought it had cleared up completely, but it returns from time to time, although less severely than before.

Karen

PS - I just received an e-mail from Amazon pushing the new Atkins book on diabetes; although I had read earlier that it was mostly written by Dr. Atkins before his death, this says it is written by two of his colleagues.

Hi Lisa, Karen was just speaking of this new book so I will be on the look out. Also the issue of Dr B speaking to the remarkable improvement he noticed in himself. I just mentioned to Karen that his observations are important even though he is coming from the perspective of a T1.

I was interested in your remark about the amount of time it would take to get any improvement in a neuropathy via LC. Do you think it would take any more time than it would if a patient were medicated in the normal ways and ate in the typical ways? You see, with that remark of yours you are moving in the direction that made me first wonder about LC and diabetic neuropathy in my own case. Conversations with my endo have been interesting on this score. For he thinks that while LC can work well in certain ways with diabetes it may not work so well in other ways, one being the recovery of certain damaged nerves resulting from the neuropathy. And since I'm the only one of his patients on LC he wants to study this further. Of course, the neuropathies are so complex they are little understood. He is particularly interested in a certain dimension of my neuropathy that involves the sensory nerves lying closer to the skin of both feet. The damaged nerves there sometimes form a very interesting pattern of flame red edema in both feet and he feels this is subtly related to very small increases and decreases in glucose in my blood. He suspects my low carb diet has exacerbated this dimension of the neuropathy. He compares my profile with various other patients he has all normally medicated and eating normally.

This is just a rought sketch of the matter. But you hit the kernel with that remark above. It also explains why I am here trying to gather any other info on the topic. The upshot as far as I am concerned is that I feel there has been some improvement over the last 2 and 1/2 years on LC even though my doctor thinks in certain ways I would not be improving as slowly if I were medicated like most diabetics and eating carbs. We have a good laugh about this view of his. He agrees my feet would be somewhat better at the expense of most likely dying sooner! I stick to LC. Brad.

Hi Lisa,

I think I must have been writing my reply to Brad at the same time as you were sending yours, as I see I repeated much of what you had already told him. Sorry about that - I didn't mean to ignore you!


Karen

If I may throw in my own two cents here. I developed neuropathy mostly in my feet but also in my abdomen area. When I was on isulin it made it very comfortable to administer the shots. I couldn't feel it! I started low carbing May 30, 2003. Since then, more of the feeling in my abdomen has been coming back. (Thank goodness I don't take insulin anymore-I don't think I could stand the pain!) My feet are taking longer for whatever reason and mostly bother me at night when my blood sugar starts to rise because of dawn phenomenon. So hopefully over time and continued success with this WOL, the neuropathy will reverse itself.

On a slightly different note, I was in a severe car accident when I was in my early twenties. I had a collapsed lung among other injuries and a breathing tube was inserted through my side into the lung to reinflate it. The doctor in the emergency room simply cut through and pushed. (Not a pleasant experience, I assure you.) Anyway, after the tube was removed (another very unpleasant experience!), I had no feeling in that area of my side just below and including the underarm area for many years. I believe the feeling started coming back when I was in my early thirties. Now I do have normal feeling in that area again. So, with that and what Lisa experienced, I would conclude that it takes a very long lime for nerves to heal. One thing to add, both Lisa and I experienced nerve damage through trauma, neuropathy is a different kind of damage, so it may take longer or less time to reverse.

I was very interested in your comment about the edema in your feet, Brad, because your description sounds very much like what has been happening to my feet recently. My ankles become very swollen and sometimes this is accompanied by a motley, bright red rash on the tops of my feet, outlined by the shape of my shoes. I saw my endocronologist (who thoroughly approves of low carbing for diabetics) earlier this week, to get the results of a 24-hour urine collection test he had ordered. He said that my kidneys are functioning at 85% of capacity, which is not out of line for someone of my age (61), and he doesn't feel that I have any diabetes-related kidney damage. I know that heart failure can also cause edema, having had two mechanical valves and a pacemaker implanted in my heart, but I have also seen my cardiologist in the last few weeeks, so I know it isn't that either. I'll be most interested in your endo's theory, if he develops it any further.

Karen

To be honest, I don't know. But...since the goal of diabetic medication is control blood glucose within a normal range as closely as possible and low carbing does that without medication (and without the spikes in blood glucose), I'd say that low carbing would prove to be a benefit in that area, not a detriment. It just seems logical to me that if you maintain your blood glucose within a narrow range through diet that it would give you a distinct advantage over someone who is experiencing wide swings in blood glucose daily by eating the typical higher carb diabetic diet and controlling with oral medication and/or insulin. Add to that paying careful attention to ensure that you get at least the RDA of vitamins and minerals and choosing the highest antioxidant foods you can for your daily menus should also prove to be of benefit.
I think also that a lot depends on the severity of the neuropathy when considering if it could be reversed and the length of time that it would take. From what you describe, you have more than just a mild case of neuropathy going on but the fact that you note that there is some improvement is at least hopeful that you will continue to see improvement with passing time. How much improvement remains to be seen but given your very good A1C readings, I can't see how medication and eating a higher carb diet could bring about a faster or better improvement unless it were acting by a mechanism other than simply better blood glucose control.
Along those lines, you may find this link helpful: http://www.jdrf.org/index.cfm?fusea...4EDC775809F79A2
It states that while hyperglycemia is the major causative factor in diabetic neuropathy, oxidative stress triggered by the hyperglycemia and the resulting response by the body to that stress also plays a part. Another good reason to make sure that your diet is high in antioxidants. :)

Karen, let me give a more detailed description of this curious red edema that occurs in my feet. Maybe it would be more helpful for comparison.

Imagine a line drawn from the gap betweent the big toe and next toe straight back along the top of my feet to just about the ankle. Not quite as far back as the ankle. The surface of the skin on the arch side of that line-this would be the area lying right behind the big toe-is the part that turns red but not like a rash with little spots. More like you could imagine a scalding with hot water. A solid red. When that happens the big toe along with the other toes will also look like they have been scalded but the redness does not include the skin on the top of my foot with any toe but the big toe. So you have a pattern of redness that extends across the toes and including the big toe and then from the big toe down to top of my foot always staying on the arch side of the line. What is striking is how straight the line is. One side redness the other side completely normal looking skin.

Where the skin is red, both the toes and the part of the surface of my foot I just described, that is where I will get slight edema. The skin just looks sort of swollen as though the swelling is ever so slightly elevating the surface of the skin. The edema you can see a little better in the toes.

This can happen to one foot but most often occurs with both and in various degrees of redness and edema. It can happen in a flash and go away in a flash. There is nothing unusual in the feeling except a slight warmness.

I actually disagree with my endo on this. As I said he thinks this is related to slight variations in my blood sugar. We will find out soon. I actually think this condition arises in my feet as a result of extenal conditions. Like the feet becoming too hot or even too cold. I agree with him though that that indicates damage to the sensory nerves but I'm not sure I'm any more susceptible to this curious condition as a result of slightly fluctuating sugar conditions. We will have to see.

Hope the more detailed description helps. By the way, the rash you are describing that appears to follow the outline of your shoes sounds almost like a heat rash. I know a guy at the gym with slightly impaired circulation who gets a similar rash on his feet that exactly follows the outline of his shoes. He for some reason has already decided this results from a slightly impaired circulation. It doesn't seen to bother him much for he seems to have a good work out. I don't know if he has a swelling in the ankles.

Thanks for your reply. Brad

Hi Lisa, yes I argued with the neuroligist about what constitutes a "mild" neuropathy. For him, if you can feel or sense coolness on the bottom of you foot you are in the mild category. That I can feel though it is impaired.

My endo thinks the irony of my condition is that with my low carb approach I am actually causing my nerves to "scream" as he puts it. They are screaming for sugar! He thinks they got used to a high sugar diet and when I in one stroke put the brakes on the sugar they protest. I found this childish image of his a little refreshing. He thinks he will be able to prove this especially by observing the aspect of the neuropathy I have described as the red edema. This part he can observe because it seems to come and go in patterns that seem controlable to him.

I think the issue is most likely divided into a symptom aspect and a healing aspect of the neuropathy. You might think the symptom aspect I am exacerbating by starving my healing nerves of the sugar they got used to therefore they scream at me. The healing side goes forward and I definitely think the LC has contributed. My endo does agree with this because he says that normal medication and diet for diabetics while sometimes making the symptoms less severe (for after all their nerves are screaming for more sugar) nevertheless in the final analysis their condition worsens.

By the way, while hyperglycemia certainly contibutes to the neuropathies I think, or my gut tells me, that soon people will realize it may not be so much that as the elevated insulin. Insulin destroys cells. That is the theory of Ron Rosedale, whose article on insulin sensitivity is online, and somehow makes good sense to me. We just speed up the natural aging process the moment insulin is pumped into our bodies. Even a healthy body. The diabetic makes this process even faster. Hence early death from many causes. Seems such an elegant theory. Have you read that article?

Thanks, Brad

My rash does sound different from what you describe, Brad. I have never heard of your situation being related to diabetes, but who knows? Your endo's theory sounds a little strange, but at least he's taking a real interest, and that's something to be grateful for. Thanks for the information.

Karen D.

Hi grannycraf! I think you are right and it is going to take some time. But grannycraf, we don't need to hasten all the problems by getting in all these accidents! But I know what you mean. A few have befallen me as well.

At least the nerves that aren't completely dead can sometimes be revived. In case you missed my suggestion try some Alpha Lipoic Acid. I am beginning to think this stuff works. Atkins recommends it too. It seems to help breathe life back into the nerve cells I think by getting them oxygen. So give it a try you never know. Good luck, Brad