This is a very interesting thread! My husband has diabetes, but no PD. And I was diagnosed with functional hypoglycemia (low blood sugar) years ago. I have had the 4-hour glucose tolerance test several times.

Diabetes Type 1 is considered an autoimmune disorder. Defined, autoimmune disease is: disorder of the body's immune system in which the immune system mistakenly attacks and destroys body tissue that it believes to be foreign. The most common diabetes is Type 2 (adult onset). This is only a theory, but one that is being researched. With the exception of a brain insult (head trauma or exposure to toxins - like pesticides), with autoimmune disease your body's immune system begins to attack itself. I have wondered if that is what is happening for those of us with PD? Could it be that our cells are dying (apoptosis) because we are predisposed to have something that attacks them within our own bodies? It certainly is suggestive of this as many with PD develop diabetes.

And I sincerely believe "what you eat is what you are." The National Parkinson Foundation (NPF) has an excellent registered dietitian (Kathrynne Holden) who has an email forum where people can write in with questions about diet and PD. Below are two very informative responses concerning protein and dairy products and PD medications:

Peg

Proteins in food can significantly block the absorption of the levodopa in Sinemet. In some people, milk proteins are especially formidable in this respect – some have stated that a single glass of milk in the morning can block their doses of Sinemet for the rest of the day.

Have you noticed, when dairy products are given, if the PD symptoms increase, along with the pain in the legs and back? If so, I would consider it very possible that she is particularly sensitive to milk proteins, and they are blocking the effects of the Sinemet. This could mean increased rigidity or cramping as you describe.

If this is the case, then she should avoid milk, yogurt, cheese, cottage cheese, and other dairy products. Instead, see if she will accept a soy or rice milk substitute, such as Rice Dream or soymilk; this can be very useful for putting on cereal, in coffee, or even drinking plain. Be sure to get the kind that is fortified with calcium and vitamin D, as it will be important for her to get enough of these.

Regarding the pain, unfortunately, the term is very vague; PD is associated with many kinds of pain – muscle/joint ache, cramping/dystonia, etc. If the pain she experiences tends to occur more often when the Sinemet wears off then it could be “wearing-off dystonia,” a kind of cramping that is often reduced when the next dose of Sinemet takes effect. There are several things that have been successful for some people, but unfortunately, not for all:
- quinine; this must be prescribed by her doctor
- large doses of vitamin E, usually starting with 1500-2000 IU/day for one or two weeks; if the dystonia lessens, then the amount of vitamin E is lowered by about 100 IU/day, until the pain begins to return. That amount of vitamin E is then determined to be the useful amount for that person
- calcium/magnesium/potassium – these minerals are all involved in muscle contraction and relaxation. If intake is insufficient, it can lead to a kind of cramping known as “tetany.” Also, if dystonia occurs, deficiencies of these minerals can make dystonia much worse. So, if the Sinemet absorption was blocked by milk, resulting in dystonia, and mineral deficiencies were also present, the pain could be exacerbated. I would ask her doctor to refer her to a registered dietitian who can determine whether her intake is adequate, and whether supplements might be helpful. Calcium citrate (especially if crushed) is better absorbed than calcium carbonate, and also does not constipate.

Kathrynne Holden, MS, RD
visit the "Discussion Corner" at the National Parkinson Foundation www.parkinson.org
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and one more:

First, if you use levodopa, you should be aware that it is among the medications that, in some people, can lead to elevated blood glucose. Therefore, it will be extra-important for you to check your blood sugar frequently, to determine whether it is a factor for you.

Carbohydrates should be unrefined for the most part -- whole grains rather than white bread/crackers, cooked dried beans, fresh fruits rather than those canned in syrup, etc. This will be very helpful with regard to PD, because these are high in fiber, which is beneficial for constipation, as well as blood pressure, and the heart.

I recommend several servings of fish per week, it too benefits both those with PD and those with diabetes, having high-quality protein, B12, and omega-3 fatty acids that protect both the nervous system and the heart.

Cinnamon has been found to help control blood glucose, and could be a good resource for you.

I recommend you ask your endocrinologist for a referral to a registered dietitian who is a certified diabetes educator. S/he can help you plan a healthful diet for diabetes, and if willing, can also address any PD-related questions to me via this forum.

Kathrynne Holden, MS, RD
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/