Foot neuropathy

PaulWright

Active Member
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32
Type of diabetes
Type 2
Treatment type
Diet only
This is my first post on this forum, though I’ve followed it regularly since I was diagnosed with type 2 diabetes in January 2015. I only went to see my GP after I suddenly developed sore feet, with the warning signs (extra thirst and small loss in weight) having been largely disregarded as there was no history of the disease in my wider family. My blood test revealed a fasting glucose figure of 18 and an HbA1c of 119. I was 63 years old at the time, 6’4” tall and a little over 15 stone so I wasn’t even particularly overweight. I immediately started a LCHF diet and lost over 2 stone in 3 months. My HbA1c fell to 49 and has been 41 or less ever since.

I’ve found maintaining a weight of around 13 stone since then very easy and can’t have much visceral fat left! This year I’ve been even stricter with my diet, having scrambled eggs for breakfast instead of Greek yoghurt (which I tended to overindulge), smaller meat portions with loads of green vegetables, and walnuts and almonds for snacks instead of cashews. I regularly test my blood and have seen a further reduction in my waking/before meal/after meal figures during the last few months. Even my waking figures, which had seldom dropped under 6 - 7, are now routinely in the 5.2 - 5.9 range. My pre-meal figure is usually in the 5’s and post-meal rarely exceed 7.

Now all this seems great, but the problem of foot pain stays with me and is the reason I wanted to post these comments. I have some limited numbness on the outer edges of both big toes, together with fluctuating levels of soreness under both feet. This has limited my ability to walk the long distances I used to enjoy, and has made driving often uncomfortable. Although prevailing medical opinion is bleak regarding this condition, with one GP just telling me to get used to it, I thought I was beginning to manage slightly better by the end of last year. This year, however, I seem to be experiencing a real setback, with a marked increase in sensitivity in my toes, soles and heels. GP’s always tell me you can’t make the nerves worse through exercise, but I have repeatedly found this is not so in my case. About 3 weeks ago I walked 5 miles during the course of one morning- way more than I’ve done since my diagnosis- and this seems to have caused (I think) a worsening of the discomfort. At present I’m resting as much as possible and avoiding mowing the lawn, washing the car etc. Extremely frustrating.

I wonder about how others have found this condition to change over time. Even with tight blood control, is it a progressive condition that inevitably has a bleak outcome? Is some nerve regeneration over time just a myth? Do you just have to accept a future of steadily diminishing ability to get about and have an active life? I’m feeling particularly depressed about this at the moment, no doubt made worse by suddenly developing tinnitus last year after nursing my dying mother through cancer. I’m told, incidentally, that extreme stress and a “flight or fight” syndrome probably caused the tinnitus.

Anyway, enough of my moans and a big thankyou for anyone who has taken the time to read through these lengthy comments.
 

Guzzler

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Hello. Have you tried r-ALA at all? Many members have good results with this but I don't think it is a prescription medicine.
 

PaulWright

Active Member
Messages
32
Type of diabetes
Type 2
Treatment type
Diet only
Well a couple of years ago I did take ALA tablets for 3-4 months without any obvious benefits. It was not r-ALA, however, and I’ve since read that those are the ones I should have tried. Given their extra cost, I’m curious whether anyone has demonstrated that their neuropathy has clearly benefited from prolonged use of r-ALA. Thankyou for reminding me about these and I suppose it would be foolish of me not to try if there’s any hope of them easing my discomfort.
 

BrianWalker

Newbie
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2
Hi. I,m in the same club with increasing discomfort in my feet, and having trouble sleeping at night, despite good glycemic control. I've tried most medications without much success and becoming slowly resigned to this condition progressing despite good glycemic control. It's a disease sadly needing a positive attitude to stay sane. I don't think there is a magic bullet but there are millions of people with this problem and we can only hope some effective treatment can be found . Stay positive and try everything, rgs Brian
 

luv2spin

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I have more or less similar issues which is very common with diabetes and my advice would be as follows as a patient;

Instead of a regular doctor please see specialist doctors,

1- Neurologist, for EMG to see the extend of loss of senses on your foot and to follow it up regularly and for prescribed medicine for the annoying feeling and the pain,

2- Cardiovascularist, for a Doppler test of your legs and foot,

3- Orthopedist, to see if the use of medical insulated silicone which one wears inside the shoes is necessary to comfort you and which type of it.

There is no such thing as damaged nerve regeneration but, the progress of it stops and does not progress with BG Control. Here, the thing is if your Blood Glucose is really in your desired range and this needs to be established with an Endo or an experienced practioner.

I wouldn't worry too much if I was to take the necessary steps to feel better.
 
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PaulWright

Active Member
Messages
32
Type of diabetes
Type 2
Treatment type
Diet only
Thanks for your detailed set of actions that I should consider. If my current worsened condition doesn’t improve, I will follow up your suggestions with my GP. I’m still curious if you can get spikes with neuropathy, as in the past I’ve had short periods of increased sensitivity and more discomfort after overdoing walking, gardening etc. These have always eased after a few days of rest. Interestingly, I tried a reflexology session, but found the kneading of my feet (not all gentle massage as I’d expected) made my neuropathy worse for a few weeks.
 

daisyduck

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Totally off on a different tack here and it might not be relevant.
You have lost a lot of weight, which means you will have lost some of the padding on the soles of your feet. This will make them more sensitive and painful on exercise.
There is a name for this .. eluding me at the moment.. but it can happen to people treated for cancer who lose a lot of weight rapidly.
I'm not sure what the remedy is but have you tried shoes/ trainers with built in shock absorbers or some really comfy memory foam insoles ?
 

PaulWright

Active Member
Messages
32
Type of diabetes
Type 2
Treatment type
Diet only
I know that as you get older the padding under your feet does get thinner, so that may well make the pain worse on my soles. I have tried scholl inner soles, but I think I do need to explore other types as you suggest. Unfortunately my neuropathy can cause great sensitivity in all my toes and tops of the feet, so socks and shoes can prove so uncomfortable to wear. This is normally tolerable, except when there is a marked spike in discomfort with constant aching. Many thanks for your input.
 

luv2spin

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Thanks for your detailed set of actions that I should consider. If my current worsened condition doesn’t improve, I will follow up your suggestions with my GP. I’m still curious if you can get spikes with neuropathy, as in the past I’ve had short periods of increased sensitivity and more discomfort after overdoing walking, gardening etc. These have always eased after a few days of rest. Interestingly, I tried a reflexology session, but found the kneading of my feet (not all gentle massage as I’d expected) made my neuropathy worse for a few weeks.

@PaulWright Since I am not a medical profession, I would say spikes could be due to other reasons as well but, I know that they are also due to neuropathy. When one is walking, due to neuropathy, we do not feel that we are not walking correctly that is our body is not putting the ideal pressure on our feet during the walk and thus it is effecting the shape of the bones and sensitive muscles on our foot and in the long run, if not taken care of, could create difficulties. The foot is one of the delicate part of the body which I did not know previously.
 
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PaulWright

Active Member
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32
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Type 2
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Yes that makes sense, and I know my gait is affected slightly as I walk. This could be a factor in lengthy walks becoming so difficult. I also wonder, but have never seen mention anywhere of this, that slight friction between very sensitive nerves and socks/shoes might in some way inflame the damaged nerves thus heightening discomfort. Who knows?
 

PaulWright

Active Member
Messages
32
Type of diabetes
Type 2
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Is it possible that you are deficient in vit B12? If you have been taking Metformin then this can affect the absorption of this vitamin which can help with neuritis/neuropathy.

Interest article here.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086960/

I was on metformin for about 18 months after my diagnosis, but stopped after my diabetes was effectively in remission. I found no change in my glucose readings, so have remained medication-free for about 2 years. You’re right that B12 deficiency is potentially an issue to watch for, but, as I eat plenty of vegetables, nuts and meat, I never thought this would be an issue for me. To be sure, I will ask my GP to include this in my next blood test. Thanks again for your thoughts.
 

Crocodile

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@PaulWright
Sorry to hear about your feet. You sound almost a carbon copy of me. I developed neuropathy in both feet and hands. I thought I good control of glucose because my HbA1c was always fine. This was back when health services began telling us that routine testing is not needed for T2. Just a 3 monthly A1c is all you need.

I did a bit of follow up on good A1c to see if after meal short duration spikes can cause neuropathy. The reason being that if they are short duration they are unlikely to impact long term average as an A1c is. I did find some research to confirm this.

https://dmsjournal.biomedcentral.com/articles/10.1186/1758-5996-6-139

My GP signed the waiver for me to get test strips and I have even tighter control now. I used to get a slight burning sensation on the toes and noticeable numbness. It has improved since I've got sugar back under control. I take R-ALA which helped a lot at first but has plateaued now. My neuropathy is still there but it isn't bad and doesn't stop me doing anything. The hands are barely noticeable now. It does waiver around in severity from time to time but on average probably not getting worse.

Nerves can heal depending on how damaged they are to begin with and it takes a very long time. I did see a neurologist. He was good at explaining everything to me and suggested no to stop walking. Try the R-ALA, it works for some so worth a shot.
Glenn
 

PaulWright

Active Member
Messages
32
Type of diabetes
Type 2
Treatment type
Diet only
Thanks Glenn.
Fortunately I’ve not experienced any problems with my hands and it just shows how symptoms vary so much with each person. The issue of after meal spikes is one I’m aware of, and it does seem this can be crucial to the management of neuropathy. Although NHS guidelines recommend blood sugar readings should not exceed 8.5% two hours after eating, I’ve read that exceeding 7.8% can potentially worsen neuropathy. For that reason I very rarely go over that figure and, having tightened my diet a bit more this year, now usually keep below 7% after meals. On that front, I’m not sure how much more I can do.

It’s interesting that there is a “fringe” view in the medical establishment that some nerve regeneration can occur over time. Even a couple of younger GPs I’ve seen have said this can occur. Much depends, I suppose, on the extent of the damage. I had wondered, when submitting my post, whether anyone with neuropathy symptoms might respond with a hopeful story of how their condition had improved over a number of years after tight control of their blood sugar. I will pursue the R-ALA supplement, and try not to listen to those who say you have to accept that it’s a progressive condition. Thanks again for your thoughts and best wishes for keeping your neuropathy at bay.
 

Crocodile

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No worries Paul, my hands are hardly noticeable so that's good. If the feet don't get any worse, I can live with it. They're not too bad, just a bit of numbness and occasional funnies at night. Sometimes the peaks aren't captured by post meal testing if it is of a very short duration. For this reason I keep my carb intake down to 20g per meal or 30g if very low on the GI scale. So far the feet aren't stopping me from doing my morning walk or working. I'm 61 now so I don't really want it to get worse right on retirement in a few years.
Glenn
 

Deltatango301

Newbie
Messages
2
Type of diabetes
Type 2
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Tablets (oral)
Hi new to forum I have just started to get nerve damage in my feet, just had a doplar test and the came up with a result of 1 and said this was a acceptable result that my blood circulation was OK so this looks like I have nerupathy in my feet, my problem is I can only walk about 50 yds before I get a feeling I am walking on plates of raw meat , also I have noticed I have a feeling of being a bit drunk when I am walking. Sorry about spelling bloody useless lol
Terry 75 years old doing the 5-2 diet since march 1 lost a Stone I have CKD thanks for reading
 

blanc71

Well-Known Member
Messages
147
Type of diabetes
Type 2
Hi Paul
It was the feet just how you described that lead me to my diagnosis.
I tried B12 supplements from Jan17 with no difference but then metformin can reduce your B12.I'm off the metformin now so time will tell.
So far my HBa are in the low 30's and have been for 6 months,but to be honest the thought of repairing nerve damage is a false hope as far as I'm concerned,you just learn to put up with the pain.