Saturday, June 14, 2014

The Nutrition Debate #218: “Diabetes Causes Nerve Pain” – NOT!

Advocacy advertising riles me all the time, almost as much as grammatical errors by news anchors, talk show hosts and United States Senators. But advertising that is misleading, especially advertising that claims that others are being misleading while being themselves misleading, is the worst. They must think we’re all dummies!

My current favorite is a teachers’ union advocating for the Common Core curriculum. In it, a teacher (or an actor playing a teacher) says (I’m paraphrasing), “those opposed to the Common Core are misleading the public”; she protests “that Common Core does NOT tell teachers HOW to teach” (emphasis mine). “THAT is misleading,” she says. What she fails to say is that the Common Core DOES tell teachers WHAT to teach! Grrrrrrrrr!

Another TV commercial I’ve heard over and over says “Diabetes causes nerve pain.” I guess it’s a scare tactic. You’re supposed to rush to your doctor and ask him to prescribe this drug. It unnerves me to hear it. Diabetes does NOT cause nerve pain. Uncontrolled diabetes may lead to all kinds of complications (read the Introduction, 2nd paragraph in particular). Uncontrolled diabetes damages the microvascular system, specifically the tiny blood vessels in the extremities (legs usually), the eyes (the retina), and the kidneys. These complications can lead to amputations, blindness and end-stage kidney disease, requiring dialysis, until the end…

The mechanism is that when the blood supply is cut off to the tiny blood vessels, they don’t supply the nerves with the oxygen they need to function (receive and send signals); thus you become insensitive to pain or injury to your feet, for example.  A cut or some other undetected injury with the slow healing of an uncontrolled diabetic can thus lead to infection, then gangrene and amputation. One leg usually leads to another and before long you’re a short-timer. Okay, I’m resorting to scare tactics too, but it’s true.

Uncontrolled diabetes is the culprit, NOT diabetes. Frankly, I don’t understand how nerve insensitivity results in pain. How can something you can’t feel be painful? But that’s not the point. The point is that uncontrolled diabetes (Am I repeating myself?) is what needs to be avoided – and “treated” when it’s encountered. The worst thing you can do is ignore a blood sugar that is not in control. Over a period of time – admittedly, years – it will manifest itself. And you will likely die from it.

Getting your blood sugar to the point where it never exceeds 140mg/dl at any point after a meal and returns to under 100 mg/dl (if you are pre-diabetic or a diagnosed type 2) should be the goal. Any postprandial excursions above 140mg/dl are going to do damage to your microvascular system, slowly, very slowly, but surely. And remember that an A1c of 7.0% (the ADA recommended target!!!) is equivalent to an estimated Average Glucose (eAG) of 154mg/dl. If you have an average blood glucose of 154mg/dl (i.e., an A1c of 7.0%, the ADA recommendation!), just imagine how much of the time your blood sugar is above 140. Now, that’s scary.

So, how to you “treat” uncontrolled type 2 diabetes? You could ask your doctor, of course. He/she will prescribe a course of oral anti-diabetes meds, and tell you to lose weight, probably on a low-fat diet (to keep your cholesterol under control). You’ll probably also need blood pressure medication, maybe a cocktail of them. Oh, and of course, a statin, to lower your Total and LDL Cholesterol (because there are medicines that do that effectively, although the benefit of doing so has not been shown). Under this regimen, type 2 diabetes is a “progressive disease.” That is, your condition will worsen so, with time, you will take more and more medication, ultimately leading to injecting insulin 4 or 5 times a day. And don’t forget the complications. They’re in your future too. This is getting too scary even for me. But there is an alternative. Interested?

YOU could treat your type 2 diabetes. That’s right, YOU. You can control your blood glucose levels simply by controlling the things you put in your mouth. The foods (and beverages) that make your blood sugar rise ALL contain carbohydrates. Carbs, both the simple sugars (mono and disaccharides) and the more complex carbohydrates (both low and high glycemic index carbs) all convert via digestion to glucose, or sugar in the blood. When they are absorbed through the small intestine into the blood stream, they circulate throughout the body as glucose, accompanied by insulin secreted in your pancreas.

If you have T2 diabetes (or are prediabetic), your body is resistant to insulin uptake, so the glucose continues to circulate. You now have impaired glucose tolerance (IGT), which leads to impaired fasting glucose (IFG). In essence, you have become carbohydrate intolerant. To control your diabetes, you need to control (i.e., limit) the amount of carbohydrates you eat. It’s that simple…and not scary at all.

I’ve been writing about this subject for a few years. I’ve been a type 2 diabetic for 28 years, the last 12 on a Very Low Carb program, eating (mostly) healthy foods. I’m human. I slip a little sometimes, sometimes a lot, but for the most part I am much, much healthier today that I was 12 years ago. That’s when I discovered how important (and easy, really) it is to eat Low Carb. And, so far, I have avoided the “dreaded complications.” You can too, if YOU take charge of your diabetes health.
 Do you know any 25+ year diabetics without complications?


  1. This commercial makes me cringe every time I see it. I always wonder if the person has been given any good dietary advice at all. I know that your feet don't become instantly numb, they burn and tingle as the nerves slowly die. Mine were gong in that direction until I got my blood sugar under good control. Thankfully, they are back to normal and nothing could make me happier.

    1. Hi Judi,
      Thanks for explaining the 'burning and tingling' thing, and congratulations on your remission and good glucose control. It's nice to have feet. They're very useful in walking.
      N.B.: This reply is repeated here since apparently a reply from my iPhone (the way I did it, at least) does not post to my blog.

  2. I have only been diagnosed with T2 diabetes for 8 years, and in the beginning I had a toe and 1/3 cut off. But I want to back up what you said in your post today. You CAN succeed if you take charge of your own diabetes health. Unfortunately, this may lead you to some run-ins with doctors who don't know what they're talking about. Step 1: Realize that there ARE doctors who really don't know what they're doing when it comes to diabetes.

    1. I'm stunned to hear about your toe loss, Jan. So sorry to hear it. But I'm also delighted that someone who was in your circumstances could and did turn things around. You probably also know Dr. Berstein's story. He had some complications too (many years ago), and decided to do something about it. He started testing, using his physician-wife's bulky testing equipment. This lead, as I understand it, to the development of the small meters that we all use today, and to his program of testing everyting to see its effect on blood sugar. Think about it. What would be be doing today if he hadn't made self-testing with this personal meter possible? I shudder to think about it. Thanks for the backup, for your continued support, and for asserting 'Step 1': I certainly agree with it.