6 Diet Tips to Help Manage Diabetes Nerve Pain

Eating right may help protect your nerves from diabetic neuropathy.
By Rebecca Buffum Taylor
WebMD Feature
Reviewed by Brunilda Nazario, MD

If you have diabetes, you already know the drill. What you eat, when you eat, and how much you eat can send your blood sugar skyrocketing -- or make it plummet. For better or worse, "diet and diabetes" go together like salt and pepper.

So if you need a little motivation to eat better - and who doesn't? - consider this: with diabetes, you're at high risk of the nerve pain and damage called diabetic neuropathy. What can start as a little tingling or numbness in your feet can turn into major problems with walking, working, and leading an active lifestyle. Diabetic neuropathy can also wreak havoc with your digestion, your sexual response, and make it hard to feel normal body sensations - like the signs of plummeting blood sugar or a heart attack.

Fortunately, a balanced diet that helps treat nerve pain is really no different than the standard diet advised by the American Diabetes Association, says Dace L. Trence, MD, an endocrinologist and director of the Diabetes Care Center at the University of Washington Medical Center in Seattle. "The emphasis is really on blood sugar control," she says. "Certainly, if a dietary change might facilitate that, of course, it would be advisable."

Good glucose control can protect the health of your nerves - and may even help prevent diabetic neuropathy, says the National Diabetes Information Clearinghouse (NDIC). You see your doctor only every once in a while, but you eat several times every day. No matter what medications you may be on, your diabetes diet has a constant - and colossal - impact on your health and well-being, with every bite you take.

Tip 1. Eat a Balanced Diet
Why? Remember the good-old food pyramid you learned about back in school? A balanced diet includes a variety of foods: carbohydrates (starches), fruits, vegetables, milk and dairy, meat, poultry, fish, and healthy fats. Eating a balanced diet helps you keep your glucose within target levels, control your weight, and reduce the risk of complications like neuropathy, heart disease, and stroke.

The goal. Step out of any food ruts you're in. Try new foods, and include all of the major food groups in your diabetes diet.

How? The shape of your diet will depend on how active you are, whether you're a man or a woman, and whether you're trying to lose weight. The American Diabetes Association offers these general guidelines, but check with your doctor to fine-tune your specific plan:

• Choose a variety of nutrient-dense foods and beverages among the basic food groups.
• Balance calories from foods and beverages with physical activity to manage body weight.
• Choose fiber-rich fruits, vegetables, and whole grains often.
• Eat 2 cups of fruit and 2 1/2 cups of vegetables daily (for someone eating 2,000 calories)
• Make at least half the grains you eat whole grains.
• Decrease saturated fats and trans fatty acids by choosing lean meats and poultry, and low-fat or non-fat dairy products.
• Substitute monounsaturated fats and polyunsaturated fats (from fish, nuts, and vegetable oils) for saturated and trans fat fats.
• Choose and prepare foods and beverages with little added sugars or caloric sweeteners.
• Eat less than 2,300 mg per day of sodium.
• Limit alcohol to no more than 1 drink for women and 2 drinks for men.
• Regular physical activity of at least 30 minutes a day for adults and 60 minutes for children.

Tip 2. Spread Your Meals Throughout the Day
Why? Skipping meals and overeating can send your blood sugar plunging - and then through the roof. Since diabetic nerve damage and pain can decrease appetite and make it harder to digest food, several smaller meals may work better for you. Plus, some diabetes medications work their best when you're taking them in concert with regularly scheduled meals.

The goal. Find a workable schedule for meals and snacks that fits your real lifestyle - not one you wish you had. Be realistic about planning your diabetes diet around your work, driving time, feeding kids, and other commitments.

How? Aim for 3 small meals and 3 healthy snacks each day to balance out your blood sugar:

• Breakfast
• A mid-morning snack
• Lunch
• A mid-afternoon snack
• Dinner
• An evening snack

Tip 3. Go for Complex "Carbs"
Why? Carbohydrates digest more slowly and don't "spike" your blood sugar the way sugars do. They also fill you up faster, so you're less likely to overeat, and they give you more vitamins, minerals, and fiber.

The goal. Most of what you eat should be healthy carbohydrates. Include whole-grains, fruits, vegetables and low fat milk. Whole grain breads and cereals, brown rice, beans, lentils, potatoes, and corn tortillas are good choices.

How?

• Shop the perimeter of grocery stores, where you'll find the freshest foods. Avoid temptation in the middle aisles, where canned, boxed, and frozen goods are shelved.
• Reach for the least-processed version of any food. Try to cut out prepared, pre-mixed foods like stove-top dinners: they're not "helpers" when it comes to diabetes and nerve pain.
• Have fun trying a new kind of starchy vegetable, like baked yams, oven-roasted carrots, or cooked lentils, instead of white rice or dinner rolls.

Tip 4. Forget "Supersizing"
Why? Most people are shocked to realize how small "official" serving sizes are. A serving of carbs? Only 1 slice of whole-grain bread or 1/2 cup of cooked oatmeal. A serving of dry cereal? Only 3/4 of a cup - that's smaller than your average cup of coffee. Meat, fish, or poultry? A mere 3 ounces is a serving - that's about the size of a cassette tape - once it's cooked. Go for that 16-ounce porterhouse and you've just eaten nearly 6 dinners-worth of protein.

The goal. Get in the habit of reading food labels to find out the real portion sizes for the foods you enjoy. And do the math. If you double up on a special treat one day, subtract that from your next day's diet planning.

How?

• Split entrees or dinner-size salads when you eat out, or have a small salad and appetizer instead of an entree.
• Keep a good diabetes diet book on hand to find portion sizes for fresh foods like fruits and vegetables.
• Buy a new set of measuring cups and spoons and keep them out on the counter, so you're more motivated to measure servings.

Tip 5. Jump on the Wagon
Why? Alcohol is toxic to nerves, says the ADA. Your liver has two main jobs: to clear toxins like alcohol from your body, and to convert carbohydrate into blood glucose your body can use. But drinking sidetracks your liver; it won't start working to level out blood sugar until it "sweeps" the alcohol from your bloodstream, so blood sugar swings can result. And if you have diabetic neuropathy, drinking may spur on pain, tingling, and other symptoms, says the ADA.

The goal. To be safe, the ADA advises people with advanced diabetic neuropathy not to drink at all, since it's possible that nerve damage can be brought on even by light drinking (fewer than 2 drinks a week). If you do drink, they advise no more than 1 drink a day for women and 2 drinks a day for men.

How?

• Try a variety of mineral waters with a fresh slice of lemon, lime, or orange for flavor.
• Make a "Virgin Mary": spice up tomato juice with a splash of hot pepper sauce, lemon juice, dried herbs, and a stalk of fresh celery - but hold the liquor.
• If you do celebrate occasionally, never drink on an empty stomach. Have your drink with or after dinner, to help prevent sugar "lows."

Tip 6. Eat Less Fat
Why? Nearly 9 out of 10 adults with type 2 diabetes are overweight, says the ADA. Losing weight can lower blood glucose, give you more energy, lighten the load on feet already sore from nerve pain, and lower your risk of heart disease and stroke.

The goal? Try to stick to 3 - 5 servings of fat a day (or as advised by your doctor). Remember that 1 serving of fat is only 1 teaspoon of olive oil or margarine.

How?

• These days, "low-fat" is everywhere. But read food labels carefully. "Lite" doesn't always mean "low-fat." Find out how many grams of fat are in each serving of the foods you enjoy.
• No matter how rushed you feel, avoid grabbing fast foods on the go. A single fast-food meal could cost you a week's worth of fat servings.
• Fill up on low-fat soups, salads with low-fat dressing, and raw veggies that satisfy your taste buds with a variety of flavors and textures.

And remember to relax and enjoy your meals. That way, you're less likely to overeat from stress, and more likely to savor the flavor of foods. Your nerves will be glad you did.