"Good" Fats
Help Prevent and Treat Diabetic Nerve Damage
By: Karlene Karst,
Dietitian
Source: Health N Vitality Magazine
Date Published: April, 2002
Did you know that 1.5 million
Canadians have diabetes and another 750,000 have diabetes and don't
know it? Diabetes is a chronic disease and is the leading cause of death
by disease in Canada. There is no cure for diabetes, but there are options
both with lifestyle changes and natural medicine that can help treat
the symptoms.
There are two main types
of diabetes. Type1 or insulin-dependent diabetes mellitus (IDDM) occurs
when the pancreas can no longer produce any insulin. It occurs most
often in children and young adults. Type 1diabetes affects about 10%
of diabetes sufferers with the other 90% having type 2 or non-insulin
dependent diabetes (NIDDM). Type 2 diabetes occurs when the pancreas
does not produce enough insulin or when the body does not effectively
use the insulin. Obesity and sedentary lifestyles are the main causes
of insulin resistance. However, non-obese people may develop Type 2
diabetes proving that obesity is not the sole cause. Considering this
evidence, researchers have been investigating a potential hereditary
component.
Obesity is leading to many
health problems such as cardiovascular disease and diabetes. The World
Health Organization and the National Heart, Lung and Blood Institute
of the National Institutes of Health have classified obesity as an epidemic.
The incidence of obesity in children and adults has increased nearly
50% in the past decade. This epidemic is a "time bomb" for
future explosion in the frequency of type 2 diabetes and its many complications.
Changes in lifestyle including
diet and exercise are key for preventing type 2 diabetes. Tight blood
sugar control is essential, which is done through diet and exercise.
Consuming a balanced diet of carbohydrate, protein and "good"
fat can stimulate weight loss, and keep blood sugars within a healthy
range. Exercise is also beneficial helping to lower blood sugar levels,
making insulin work better and the exercise will aid in weight loss
at the same time improving overall health. Also, weight loss often results
in major improvements in blood sugar control in patients with Type 2
diabetes.
People with diabetes are
at risk for developing complications, therefore it is very important
to monitor blood glucose levels, keep within a healthy body weight,
and consume a healthy diet to help prevent or delay the onset of complications.
However, approximately 40% of diabetics will develop complications due
to the disease. There are three main categories of possible complications:
- Microvascular complications-small
blood vessel damage. These include retinopathy, impairment or loss
of vision due to damaged blood vessels in the eyes, nephropathy, disease
to the kidney due to blood vessel damage, and neuropathy-nerve damage.
- Macrovascular complications-large
blood vessel damage. This includes cardiac problems and hypertension.
- Other complications including
infections of mouth, gums, urinary tract, impotence, and pregnancy
complications
All complications of diabetes
are serious, however, neuropathy- nerve damage caused by a prolonged
imbalance in blood glucose levels affects 40-50% of people with diabetes.
Symptoms of neuropathy include numbness and sometimes pain in the hands,
feet, or legs. This affects internal organs such as the digestive tract,
heart, and sexual organs, leading to symptoms such as diarrhea, constipation,
indigestion, dizziness, and bladder infections. Neuropathy
can also lead to impotence, which afflicts approximately 9% of all diabetic
men.
In severe forms, neuropathy
can lead to lower limb amputations, and is the leading cause of all
non- accident related amputations. Each year, more than 56,000 amputations
are performed among people with diabetes. Lower extremity amputation
is eleven times more frequent for people with diabetes than people without
diabetes.
No pharmaceutical treatment
exists for diabetic neuropathy. While diet and exercise are important
for diabetes, physicians recommend close monitoring of blood sugar levels
as the best way to prevent complications such as neuropathy. In theory
close blood sugar monitoring is the best way to prevent the onset of
neuropathy, but in practice it is very difficult for diabetics to achieve.
Even the most conscientious diabetics experience considerable fluctuations
of blood sugar levels.
There is hope for improving
the symptoms of neuropathy. Certain natural products have been proven
successful in moderating the effects of diabetes and neuropathy. Essential
fatty acids, or "good" fats such as gamma-linolenic acid is
an important factor contributing to prevention and improvement of neuropathy.
Antioxidants such as alpha-lipoic acid have proven synergistic effects
with GLA in the treatment of neuropathy.
In the last 20 years, research
with both animals and humans has demonstrated the value of GLA. GLA
is a naturally occurring fatty acid found in borage, evening primrose
oil and black currant oil. A healthy body can convert linoleic acid
(LA) found in many processed foods, margarines and vegetable oils to
GLA. The body can then use GLA for building nerve structure. The metabolites
of GLA are required for healthy nerve function, however with diabetes,
the initial conversion of dietary LA to GLA is often impaired. The result
is a lower level of GLA and its metabolites in the tissue. The key to
improving diabetes and neuropathy is to restore GLA to normal levels
through dietary supplementation.
Human clinical studies have
concluded that GLA has a beneficial effect on the course of diabetic
neuropathy. Trials began in 1986, when a group of researchers conducted
a double-blind, placebo-controlled study with 22 patients. The treatment
group received 360 mg of GLA per day for 6 months. All tested variables
improved in the treatment group and worsened in the placebo group.
With these positive results,
additional research was pursued. Two subsequent multicenter studies
including more than 400 patients, obtained consistently positive results.
The first included 111 patients in 7 centers, while the second included
293 patients in 10 centers. The patients received 480 mg of GLA per
day for one year. The researchers measured 16 parameters in all, including
nerve conduction strength and speed, hot and cold thresholds, sensation,
reflexes, and muscle strength. After a full year of treatment, all 16
parameters showed favorable improvement as compared to the placebo group.
Now laboratory research indicates
that recovery of patients may be even more complete when GLA is used
in conjunction with anti-oxidants. Alpha-lipoic acid is a powerful anti-oxidant
found in foods such as potatoes, red meat and spinach. It plays an important
role in the body's ability to burn blood sugar thus helping to sustain
normal blood sugar levels. An animal study combining GLA with alpha-lipoic
acid showed great improvements in motor skills and blood flow deficits
associated with neuropathy. Researchers noted this synergistic combination
far outweighed the effects of each supplement used separately.
To get the GLA you need,
the best source is borage oil containing up to 24% GLA. Evening primrose
oil (8-10% GLA) and black currant oil (15-17%) are other sources, but
because of the higher concentration of GLA in borage oil, a patient
will have to consume fewer capsules. Clinical research indicates that
a dosage of 500 mg GLA per day is effective. That's only 2 grams of
borage oil daily.
By making modifications to
diet, lifestyle and by incorporating "good" fat like GLA and
anti-oxidants such as alpha-lipoic acid, preventing diabetes and its
complications of neuropathy, cardiac problems and hypertension is possible.
For more information, or
references for this article, please contact Karlene Karst at kkarst@bioriginal.com
About Karlene Karst
Karlene Karst is the clinical
research and education coordinator at Bioriginal Food and Science Corp.
She provides technical and regulatory advice on EFAs, as well as educational
seminars, lectures and presentations on the role of EFAs in nutrition
and health. Karlene holds a Bachelor of Science degree in Nutrition
from the University of Saskatchewan's College of Pharmacy and Nutrition.
She is also a registered dietitian and has previously worked as a clinical
dietitian.
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