Triglycerides and Neuropathy

Patient Expert

Until now our doctors have lacked an effective way to predict who is at the greatest risk of neuropathy. Usually we find out too late --   when irreversible nerve damage has already occurred.

Diabetic neuropathy is the most common microvascular complication we have. More than half of all people with diabetes develop neuropathy. It is a complication in both type 1 and type 2 diabetes.

In the past few years the U.S. Food and Drug Administration approved two drugs -- Cymbalta and Lyrica -- for managing the pain of diabetic neuropathy. These drug help many of us. But wouldn't it be a lot better for us if we could prevent diabetic neuropathy?

Now, maybe we can. It's a standard and simple test of the level of blood fat that we have. The common blood test for triglycerides -- a well-known heart risk factor -- may also tell us if we are at risk for neuropathy.

Researchers at the University of Michigan and Wayne State University analyzed data from 427 people with diabetes who suffered from   neuropathy. Diabetes, a professional journal of the American Diabetes Association, will publish the study, "Elevated Triglycerides Correlate with Progression of Diabetic Neuropathy," in its July issue. The abstract is online, and my friend Dr. Bill Quick kindly sent me the full text.

The researchers found that elevated triglycerides correlated with the nerve fiber loss independent of disease duration, age, diabetes control, or other variables. High levels of triglycerides turned out to be more likely to lead to neuropathy than high blood glucose levels.

"People can reduce blood triglyceride levels with the same measures that reduce cholesterol levels," according to a University of Michigan Health System press release, "by avoiding harmful fats in the diet and exercising regularly." Maybe.

But that never worked for me. The normal level of triglycerides is below 150 mg/dl. My level was usually higher, up to 176 -- until I started a very low-carbohydrate diet. Just two months later my level dropped to 47 and has stayed in that range ever since.

My experience is typical. It is the consumption of high levels of carbohydrate that drive high triglyceride levels, says Dr. Michael Eades.

"After years of low-carb dieting myself and of taking care of thousands of patients on low-carb diets, I can tell you one thing with pretty much certainty: Low-carb diets reduce triglyceride levels markedly," he writes. "On a low-carb diet, these patients drop their triglyceride levels like a rock."

This leaves us with a clear choice. We can wait until we get neuropathy and treat it with one of the available drugs. Or we can prevent it by testing our triglyceride level. And if that level is too high we know what to do.