In diabetic mice, restoring serine through dietary supplementation, together with the drug myriocin to fix abnormal fat levels, alleviated neuropathy. The study, published in Nature, found serine and glycine run low in diabetes and metabolic syndrome. And that shortage speeds up small fiber nerve damage.
Diabetes is a long-term disease of the body’s fuel system. Blood sugar runs high because the body cannot make insulin or use it well. The two main types are type 1 and type 2. Type 1 diabetes is an autoimmune disorder that usually starts in children and young adults. The immune system attacks and destroys the cells in the pancreas that make insulin. That leaves the body short of insulin. Type 2 diabetes usually starts in adults. It comes from insulin resistance plus less insulin made by the pancreas. One of the most common problems of diabetes is diabetic neuropathy. That means damage to the nerves that carry signals between the brain, spinal cord, and the rest of the body. It can hit nerves for feeling, nerves for movement, and nerves that run organs. So symptoms vary a lot. They include numbness, tingling, pain, weakness, poor balance, and stomach problems. Diabetic neuropathy gets worse over time. How bad it gets, and how fast, differs from person to person. The exact cause is not fully known. High blood sugar, oxidative stress, inflammation, and metabolic imbalances are thought to damage the nerves. Diabetic neuropathy can be hard to treat. There is no cure. Today’s treatments aim to manage symptoms and slow the disease. Options include pain relievers, antidepressants, and seizure drugs, which can ease pain and help nerve function. Lifestyle changes may also help. These include eating well, exercising regularly, and quitting smoking. In severe cases, nerve decompression surgery or spinal cord stimulation may be considered. But treating diabetic neuropathy has several challenges. First, its symptoms can overlap with other conditions. That makes diagnosis and care harder. Second, there is no standard treatment plan. How well a treatment works can depend on the kind of nerve damage, how bad it is, age, and other illnesses. Third, some nerve pain drugs have side effects and interactions with other drugs. They may not suit all patients, especially those with other health problems. Last, cost can be a barrier. Some drugs and procedures for neuropathy are expensive and may not be covered by insurance.
Can serine supplements help diabetic neuropathy?
The study, published in Nature, looks at amino acids the body can make itself. Two of them are serine and glycine. They run low in people with metabolic syndrome, diabetes, and other nerve problems. The researchers found that this shortage of serine and glycine may play a part in the pathogenesis of diabetes and other associated complications. The study used diabetic mice. The body was handling serine badly. That is why serine and glycine were low. They built a test, the serine tolerance test, to see how mice take in and clear serine. They limited serine and glycine in the diet of young mice and fed them a high-fat diet. That sped up small fiber neuropathy, a type of nerve damage common in people with diabetes. Then they brought serine back to normal with diet. They also used a drug called myriocin to fix dyslipidemia (abnormal fat levels). With both, the nerve damage eased in the diabetic mice. The researchers concluded that low serine and bad blood fats are risk factors for nerve damage. They may also feed diabetes and its problems. They suggest two ways to manage nerve damage in diabetes. Add serine and glycine to the diet. And use drugs that fix blood fats. In short, serine and glycine matter in how diabetes and its problems grow. Fixing these amino acids and blood fats could help manage nerve damage in diabetes.
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Frequently asked questions
Is it possible to reverse diabetic neuropathy?
There is no cure for diabetic neuropathy today. Current treatments manage symptoms and slow the disease. The serine study is interesting because it went after a cause. In diabetic mice, bringing serine back to normal with diet, plus the drug myriocin to fix abnormal blood fats, eased the nerve damage. That result comes from mice. So it points to a possible strategy, not a proven treatment for people.
What medications are used to treat diabetic neuropathy?
The usual options are pain relievers, antidepressants and seizure drugs. They can ease pain and help nerve function. But they can have side effects and drug interactions, and they do not suit every patient. A healthy diet, regular exercise and quitting smoking also help. In severe cases, nerve decompression surgery or spinal cord stimulation may be considered.
What causes diabetic neuropathy?
High blood sugar, oxidative stress, inflammation and metabolic imbalances are all thought to damage the nerves. But the exact cause is not fully known. The Nature study adds two risk factors. One is low levels of the amino acids serine and glycine. The other is dyslipidemia, meaning abnormal fat levels in the blood. Both seem to feed nerve damage in diabetes.
Does low serine cause nerve damage?
In the study, low serine sped up nerve damage. Young mice ate a high-fat diet low in serine and glycine. They developed small fiber neuropathy sooner. That is the type of nerve damage common in people with diabetes. Serine and glycine also run low in people with metabolic syndrome, diabetes and other nerve disorders. That is why the researchers call a serine shortage a risk factor.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
