Diabetes & Peripheral Neuropathy
Diabetic neuropathy can be treated with exercise, acupuncture, topical bitter melon, and other naturopathic approaches. Peripheral neuropathy affects between 30-50% of patients with diabetes. Patients can experience sensory loss, pain, unusual sensations and muscle weakness. As a result of sensory loss, patients may be unaware of minor scraps and cuts resulting in dangerous infections. Since diabetes interferes with wound healing and promotes bacterial overgrowth it makes things worse. Foot ulcers can occur in 15% of patients. Thus it is important to target treatments not only at the neuropathy itself, but also at wound healing and microbial infection prevention. Damage can be due to hyperglycemia as well as chronically elevated insulin levels. For impact on neurological function click here.
What could be more important to nerve function and metabolism than exercise? This is a rhetorical question. Exercise continues to offer significant benefit in terms of prevention, risk reduction, improvement of insulin resistance, weight management… And yes – benefit to peripheral nerve function!
Aerobic exercise helps with symptoms and may even stimulate re-growth of small nerve fibers.
Weight-bearing exercise, like trampoline use, improves range of motion as well sensation of vibration. Absence of vibration sense is evidence of neuropathy.
According to a 2017 systematic review – acupuncture has a lot to offer for neuropathies, especially those caused by diabetes! Various protocols are effective including combination of needling along with electrical stimulation being applied to specific points. As frequently seen with traditional acupuncture the points that are selected include both local and distal points.
This treatment is safe and effective for improving symptoms of numbness and pain.
- Momordica charantia – also known as bitter melon. Momordica improves fasting and post-prandial blood glucose when consumed either as juice, friend fruit and/ or powdered extract. The topical ointment made from bitter melon can promote wound healing. This is critical for patients with diabetic neuropathy. Due to reduced sensation patients are often unaware of minor cuts and scraps, which unfortunately take longer to heal than usual (3), (4). (For delicious recipes using bitter melon click here).
- Honey – Medi-Honey has been shown to be effective for the treatment of burn wounds. While further research is needed to determine the effectiveness of honey on diabetic wound healing, studies confirm safety.
Alpha-lipoic acid is an potent antioxidant. Additionally it stimulates blood flow to the nerves and increase metabolism. Oral supplementation improve nerve conduction and improves symptoms of pain, numbness and paresthesias. While intravenous therapy offers faster more effective relief, oral delivery is still effective. Possible side effects can include stomach upset, headaches and rashes. It is important to start at slow and increase the dose gradually over the course of several weeks to avoid these effects (5).
Acetyl-L-carnitine may improve neuropathic symptoms. L-carnitine is also a potent antioxidant. It has been shown to be effective in various cognitive conditions as well as heart and renal failure. However, the results in diabetic neuropathy are mixed with some studies reporting significant improvement in neuropathy, while others demonstrating no effect.
Additional therapies to consider include Ginseng and Fenugreek, but further research is needed to assess the efficacy of these two herbs.
- Singleton J. Exercise as therapy for diabetic and prediabetic neuropathy. Curr Diab Rep. 2015; 15(12): 120
- Dimitrova A. Acupuncture for the treatment of peripheral neuropathy: a systematic review and meta-analysis. J Altern Complement Med. 2017; 23(3): 164-179
- Joesph B. Antidiabetic effects of Momordica charantia (bitter melon) and its medicinal potency. Asian Pac J Trop Dis. 2013; 3(2): 93-102
- Hussan F. Momordica charantia ointment accelerates diabetic wound healing and enhances transforming growth factor-Beta expression. J Wound Care. 2014; 23(8): 400-7
- Halat K. Botanicals and dietary supplements in diabetic peripheral neuropathy. J Am Board Fam Pract. 2003; 16: 47-57