Diabetic Neuropathy – B12 Helps While Vegan Diet Minimal Effects

Though 20 week vegan diet touted as helping diabetic neuropathy, its pain levels were no different than the B12 control and the foot skin conductance was not different. Only diffence was in McGill Pain questionnaire in the sensory fields. Unfortunately, these fields are not mutually exclusive so the same thing could be added up several times eliminating their p=0.04 significance. A difference in neuropathy scale would suffer from same issue. Yet if you look in the free press, vegan diet may be the next best thing for DM neuropathy..

http://consumer.healthday.com/diabetes-information-10/diet-diabetes-news-178/vegan-diet-might-ease-diabetic-nerve-pain-699793.html

I have written the author for clarification.


A dietary intervention for chronic diabetic neuropathy pain: a randomized controlled pilot study
A E Bunner, C L Wells, J Gonzales, U Agarwal, E Bayat and N D Barnard
Nutrition & Diabetes (2015) 5, e158; doi:10.1038/nutd.2015.8
http://www.nature.com/nutd/journal/v5/n5/full/nutd20158a.html

  • Only 17 in each group – usually one would like 40 in each group to get clear evidence of effect.
  • 20 weeks
  • B12 1000mvg/day in each group

Results:

dm_neuropathydm_skin conductThere were difference in the sensory component of the McGill pain questionnaire however they contain factors that are nor mutually exclusive and would be hence added several times to exaggerate any difference. As it was they only obtained a p=0.04 difference which is statistically different, but unlikely to be clinically so at that level. They noted differences in a Neuropathic pain questionnaire which has factors added up repeatedly.

Why the skepticism?  Well, B12 has major effect on diabetic neuropathy:
Maladkar, Manish, et al.
Efficacy, safety, and tolerability of Epalrestat compared to Methylcobalamine in patients with diabetic neuropathy.
International journal of diabetes in developing countries 29.1 (2009): 28.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802362/

b12_dm_neuropathy

Comment – My Daughter, Dr. Janice Montbriand and myself presented a poster at the Canadian Pain Society 2013 in which we showed that high dose B12 given 1000 mcg near daily subcut. has an analgesic effect which also augments the effects of gabapentin or pregabalin. This would especially help DM neuropathy which is the only thing this study has shown for certain. The did achieve 6.4 kg of weight loss but any new diet can do that. Need a better study..

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