Fat rather than sugar may be the most significant culprit in the development of diabetic neuropathy in Type 2 diabetics. Diabetic neuropathy is the most common complication of diabetes. It can occur anywhere but commonly in legs and feet leading to symptoms such as numbness, loss of sensation and pain. The accepted understanding of peripheral neuropathy in both Type 1 (T1D) and Type 2 diabetics (T2D) is that chronically high blood sugar levels cause it, which results in damage to nerves.
In a study of TID and T2D, magnetic resonance images (MRI) were used to see if there were different associations between neuropathic symptoms and metabolic indices including blood sugar control and lipid metabolism. What emerged is that there are differences in the type of nerve damage between T1D and T2D and further that the damage is likely to be caused by different metabolic factors. In TID the association between loss of nerve conduction and poor blood sugar control was strongly confirmed. However in T2D the predominant nerve lesions were associated with changes in lipid metabolism including elevated serum triglycerides and reduced HDL (healthy cholesterol) rather than poor blood sugar control. It is important to note that in T2D poor blood sugar control and unhealthy lipid metabolism occur hand in hand, which means that improving glycaemia control is still central to effective management of T2D overall. However, it now seems that focussing on healthy lipid metabolism may also become a central treatment focus in T2D with the aim of helping to prevent the progression of diabetic neuropathy.
While this research is still in the investigative stages there is great benefit from eating a diet that promotes healthy cholesterol ratios including these suggestions:
- Choose olive oil instead of margarine, butter or mayonnaise.
- A daily serving of nuts or avocado promotes a healthier cholesterol ratio.
- A Mediterranean style-eating pattern also promotes health ratios.
Jende, J. M., Groener, J. B., Oikonomou, D., Heiland, S., Kopf, S., Pham, M., … & Kurz, F. T. (2018). Diabetic neuropathy differs between type 1 and type 2 diabetes Insights from magnetic resonance neurography. Annals of neurology.