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A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study.
Nutr Diabetes 2015; 5:e158ND

Abstract

BACKGROUND

Diabetic neuropathy is a common and often debilitating condition for which available treatments are limited. Because a low-fat plant-based diet has been shown to improve glycemic control in individuals with type 2 diabetes, we hypothesized that such a diet would reduce painful symptoms of diabetic neuropathy.

METHODS

In this 20-week pilot study, individuals with type 2 diabetes and painful diabetic neuropathy were randomly assigned to two groups. The intervention group was asked to follow a low-fat, plant-based diet, with weekly classes for support in following the prescribed diet, and to take a vitamin B12 supplement. The control group was asked to take the same vitamin B12 supplement, but received no other intervention. At baseline, midpoint and 20 weeks, clinical, laboratory and questionnaire data were collected. Questionnaires included an analog 'worst pain' scale, Michigan Neuropathy Screening Instrument, global impression scale, Short Form McGill Pain Questionnaire, Neuropathy Total Symptom Score, a weekly pain diary and Norfolk Quality of Life Questionnaire.

RESULTS

After 20 weeks, body weight change with the intervention was -6.4 kg (95% confidence interval (CI) -9.4 to -3.4, P<0.001) in an effect size analysis. Electrochemical skin conductance in the foot improved by an average of 12.4 microseimens (95% CI 1.2-23.6, P=0.03) with the intervention in an effect size analysis. The between-group difference in change in pain, as measured by the McGill pain questionnaire, was -8.2 points (95% CI -16.1 to -0.3, P=0.04). Michigan Neuropathy Screening Instrument questionnaire score change was -1.6 points (95% CI -3.0 to -0.2, P=0.03).

CONCLUSIONS

Improvements were seen in some clinical and pain measures. This pilot study suggests the potential value of a plant-based diet intervention, including weekly support classes, for treating painful diabetic neuropathy.

Authors+Show Affiliations

Physicians Committee for Responsible Medicine, Washington, DC, USA.Physicians Committee for Responsible Medicine, Washington, DC, USA.Physicians Committee for Responsible Medicine, Washington, DC, USA.California State University, East Bay, Student Health and Counseling Services, Hayward, CA, USA.George Washington Medical Faculty Associates, Washington, DC, USA.1] Physicians Committee for Responsible Medicine, Washington, DC, USA [2] George Washington University School of Medicine, Washington, DC, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26011582

Citation

Bunner, A E., et al. "A Dietary Intervention for Chronic Diabetic Neuropathy Pain: a Randomized Controlled Pilot Study." Nutrition & Diabetes, vol. 5, 2015, pp. e158.
Bunner AE, Wells CL, Gonzales J, et al. A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study. Nutr Diabetes. 2015;5:e158.
Bunner, A. E., Wells, C. L., Gonzales, J., Agarwal, U., Bayat, E., & Barnard, N. D. (2015). A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study. Nutrition & Diabetes, 5, pp. e158. doi:10.1038/nutd.2015.8.
Bunner AE, et al. A Dietary Intervention for Chronic Diabetic Neuropathy Pain: a Randomized Controlled Pilot Study. Nutr Diabetes. 2015 May 26;5:e158. PubMed PMID: 26011582.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study. AU - Bunner,A E, AU - Wells,C L, AU - Gonzales,J, AU - Agarwal,U, AU - Bayat,E, AU - Barnard,N D, Y1 - 2015/05/26/ PY - 2015/02/05/received PY - 2015/03/12/revised PY - 2015/04/09/accepted PY - 2015/5/27/entrez PY - 2015/5/27/pubmed PY - 2015/5/27/medline SP - e158 EP - e158 JF - Nutrition & diabetes JO - Nutr Diabetes VL - 5 N2 - BACKGROUND: Diabetic neuropathy is a common and often debilitating condition for which available treatments are limited. Because a low-fat plant-based diet has been shown to improve glycemic control in individuals with type 2 diabetes, we hypothesized that such a diet would reduce painful symptoms of diabetic neuropathy. METHODS: In this 20-week pilot study, individuals with type 2 diabetes and painful diabetic neuropathy were randomly assigned to two groups. The intervention group was asked to follow a low-fat, plant-based diet, with weekly classes for support in following the prescribed diet, and to take a vitamin B12 supplement. The control group was asked to take the same vitamin B12 supplement, but received no other intervention. At baseline, midpoint and 20 weeks, clinical, laboratory and questionnaire data were collected. Questionnaires included an analog 'worst pain' scale, Michigan Neuropathy Screening Instrument, global impression scale, Short Form McGill Pain Questionnaire, Neuropathy Total Symptom Score, a weekly pain diary and Norfolk Quality of Life Questionnaire. RESULTS: After 20 weeks, body weight change with the intervention was -6.4 kg (95% confidence interval (CI) -9.4 to -3.4, P<0.001) in an effect size analysis. Electrochemical skin conductance in the foot improved by an average of 12.4 microseimens (95% CI 1.2-23.6, P=0.03) with the intervention in an effect size analysis. The between-group difference in change in pain, as measured by the McGill pain questionnaire, was -8.2 points (95% CI -16.1 to -0.3, P=0.04). Michigan Neuropathy Screening Instrument questionnaire score change was -1.6 points (95% CI -3.0 to -0.2, P=0.03). CONCLUSIONS: Improvements were seen in some clinical and pain measures. This pilot study suggests the potential value of a plant-based diet intervention, including weekly support classes, for treating painful diabetic neuropathy. SN - 2044-4052 UR - https://www.unboundmedicine.com/medline/citation/26011582/full_citation L2 - http://dx.doi.org/10.1038/nutd.2015.8 DB - PRIME DP - Unbound Medicine ER -