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Diabetes Complications

Triglycerides and Neuropathy

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.

This article is based on an earlier version of my article published by HealthCentral.

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  • becky at

    I had a cerebellar stroke – L. vertebral artery collusion, a month ago yesterday, with fortunately no physical/mental residual effects except for dizziness and headaches behind my L. ear (site of CVA) and occasional ‘neural’ burning feelings in that area.
    I have a Hx. of high triglycerides – 242 last month, too low HDL and slightly elevated LDL. I am on 4 Lovaza/day, pravachol (just since CVA), and gemfibrozil BID. I also have BP which is controlled by benazepril /HCTZ in am and Toprol-XL 50 + 1/2 benazepril in pm & potassium chloride in am. I also take synthroid 75 mcg, aspirin 325, and estrogel daily. NeuroMD advised I use Tylenol for headaches. Started me on Coumadin 5mg Thursday, after a brain angiogram where they found the cause of CVA.
    I inherited the chol/trigl. from my Father who had heart attack at 42 w/CABG X2, then Hx. of angioplasty’s and other Tx’s, subsequent death at 78 of heart attack, and my maternal grandmother suffered a “BP stroke” at age 54 – High BP runs on that side of the fly.
    I also take metformin s/p ~3 years due to borderline DM… Daddy and whole Fly. has Hx. of that too. Lost his sister, my aunt this year to pancreatic CA, his Mother same 10 years ago.
    Ed, Until now I was a stressed out workaholic who ate fast food every day and never excercised. After being home for this past month, & unable to drive due to the dizziness, I am taking heed. I’ve read alot of the info on your website. It’s so very informative but alot to take in. I’m asking for specific help in what sort of diet to follow NOW. I plan to begin walking today. And I am READY and WILLING and asking for your help to revamp my eating habits, please. I am an Occ. Therapist and musician, and also plan to revamp my work and exercise habits.
    thank you so much and God Bless You
    I’ve gone from basically

  • Ed at

    Dear Mike –

    Or, you could try fish oil.

    After being a type 1 for 46 years my most recent blood lipid profile is:

    cholest 115
    trigly 45
    HDL 65
    CHOL/HD 1.8
    LDL calc 41



  • David Mendosa at

    Dear Mike,

    I agree with Dr. Richard K. Bernstein about now many grams of carbs to eat per day.

    As I wrote at http://www.mendosa.com/bernstein.htm “He prescribes 6 grams of carbohydrates for breakfast and 12 each for lunch and dinner. In addition, he allows 12 grams per snack, but since the snack and the following meal must be on an empty stomach — 4 hours apart — this diet allow no more than a grand total of 42 grams carbohydrate each day.”

    We don’t need to go any lower than that to control our diabetes and, as Dr. Bernstein says, carbohydrates may provide something that we need but don’t know of yet. But there is absolutely no known need for ANY carbohydrates in our diets. We absolutely do need protein and fat but for years we have had clear proof that we don’t need any carbs. Please see http://www.mendosa.com/stefansson1.htm as well as the link to the “Journal of Biological Chemistry” article and the Dr. Stefansson’s two following articles.

    Best regards,


  • Mike at

    this answers some questions for me but what is a safe number of carbs per day on a low carb diet. It can be just as unhealthy to get too few carbs as too many.