diabetic neuropathy

[jar]

Hi All
I have been type 2 for ten years, started on metformin eighteen months ago when my HBA1C spiked to 7.7 now taking 1500mg per day. My Hba1C is normally between 6.9 and 7.1 the last being exactly 7.0. I have now developed Neuropathy on my feet and unusually on the end of my nose, I also have background retinopathy. My DN says that she feels my Blood sugar control is good and that I am just unfortunate to have these complications. Do you think that she is correct in saying this or do others out there have complications at this HBa1C level?
Just started taking Prebgablin for the neuropathy and after 7 days the pain, burning, and tingling in my feet has become slightly less.
Any thoughts on the above would be appreciated
Thanks JAR

 

[Daibell]

Hi. Those HBa1Cs aren't too bad so your nurse isn't far off the mark. I would try to get the HBa1C down a bit further if you can as every little helps. I assume you're having a sensible low-carb diet etc. If you're not overweight it may be worth discussing adding some Gliclazide to your meds?

 

[weeezer]

Hi. I'm t1 (13 years) and hba1c is usually in the 6s. My latest was 7.1, which I feel was higher than I'd like, but doc says that's great. Whichever doc I've ever seen says great control. However, I also now have background retinopathy (since 2010 after being pregnant with 2nd child) and the buzzing/tingling feet since jan this year which doc said was most likely the start of peripheral neuropathy I thought all this 'great control' would save me from this, but looks like it hasn't after all.

Really down about it, feels like a death sentence (yes, dramatic, but it's hanging round my neck is what I mean).

So...yep, even with good control these things can still occur


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[jar]

Thanks for your reply weeezer. I am in awe of type 1s who manage to run a family and cope with injections etc I bet your daughters are as well!!
The thing to remember with neuropathy is that the pain and sensations can be managed with medication, so don't let it get you down.
Jar

 

[hanadr]

Jar
With all respect to your nurse. In her experience, low HbA1cs are probably rare and she likely thinks they are danerous, however to have an hbA1c of 7.0 you need an average blood glucose of 9.6. since normal non-diabetic blood glucose hovers around 5 with an hbA1c of around 4.6%
Your numbers are probably much better than she sees in other patients, but they are not low enough to protect you.[ a clinic sister that I know told me she sees mostly patients with Hb A1cs in double figures. You are definitely better than that.
StillI would suggest that you try to get down lower. It is possible to reverse complications with really good control.
My personal view is that the only reference points that matter are the levels of non-diabetics. I think healthcare professionals are trying to make the best of what patients accept as easy answers.
I've given blood glucose meters to non-diabetic people to play with and only ever once seen a reading of over 8mmol/l and that in a person who had recently had a pasta bake lunch and was in a high risk group. Yet if you look at targets set by Diabetes UK and NICE, you'd get the impression it is fine/safe to have such a level.
Hana

 

[weeezer]

Thank you jar! It's tough for anyone to 'manage' this condition and live a busy life lets face it! I've always thought i was doing well, but I am not satisfied with that any more, I want 'excellent'! And realise that required a little more focus & involvement.

Hanadr, where is that average bg figure from? I thought my hba1c of 7.1 meant an average of 8.7 according to the converter on this website, 7 is equivalent to 8.6?? (Admittedly, still too high! I strive for, and usually achieve, hba1c's in the 6s, pref 6.5 and under). Totally agree that medical professionals are very happy with this figure, and can't understand it when I am not!


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[Sameer]

I really dont understand h1bc 6.5 to 7.5 is this dangerous ...... I mean does this make you feel **** !!!


Setting my dose .....on novomix 30 !!!
Currently morning 10 units and before dinner 14 units
Will stick to this !!!
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[sean51]

My hba1c is 6.5 (47) still have all the on going symptoms stinging feet, dizzy spells ,diarea,constipation,so only thing to do is keep to diet and if able exercise everyday


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[hanadr]

Figures for mmol/l to Hb A1c conversion vary a bit from one authority to another.
It's still not easy to find a value for non-diabetics. i know one of the meter companies does a survvey qannually, but haven't accessed their data. I found figures on the leaflets that come with test strips. and in Richard Bernstein's books.
The last time i let people "play" with a meter was at a BMA meeting and they were all junior doctors. They were surprised that my BG number was lower than theirs. I had salad for lunch, they had a pasta bake.
One further problem on these numbers is the existance of the ACCORD study, which purports to show that Hba1cs which are low, lead to excss numbers of deaths. Having read the wretchedd thin [which is very turgid!] I concluded that it showed that blood glucose control by multiple high doses of medication is dangerous. After all if Low hb A1cs were in and of themselves harmful, why aren't all the non-diabetics dropping like flies?
Hana

 

[KennyS]

I was getting ready to reply almost exactly as did hanadr. As close to normal blood sugar should be the goal of anyone interested in mitigating the damage done by high blood sugar. While I have not seen a conclusive study that shows tight control able to reverse damage, it has been proven without doubt that it will halt or dramatically slow neuropathy. By the way, the conversion for HbA1c to average blood sugar is http://www.diabetes.co.uk/hba1c-to-bloo ... erter.html . As hanadr said, 7.0HbA is, to my mind, an astronomical reading of 9.6....

Obviously everyone is different and their ability to control blood sugar levels are impaired to a lesser or greater extent. My comments an the levels I seek are within my ability. If you do all you can but are unable to reach those levels... that my friend is the best you can do.

Kenny

 

[sean51]

Spot on kenny

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[renee]

Hello I'm Renee ! I don't get too much feeling in my fingers on occasion other parts. Some one asked about Metformin on here. Iv'e been Diabetes 2 for 12 years. Our Doctor does not think more than 500 metformin is a good Idea. He says it increases the chance of more than usual Hypo's. Also my eyesight has suffered with the diabetis . But on the plus side I get along o.k. I don't know about anyone else but I test when I think I'm low. But have to fight for my strips. My Meter is so old I don't know if its working properly at all Its a Contour given to me by Diabetes UK. some years back. I don't worry about the diabetes. Even Though my Mum died with it many years ago. Also Better tell you I'm 86 yrs old so must be doing something right. :wave:

 

[susan53]

Hi Everyone
I really don't know where to start so the beginning seems to be the best place. About 10 years ago I had problems with my little finger and half of the next finger it was numb and stiff or bent (if cold could not use it). Anyway after seeing a Consultant was told the use I had was the same as he would get with an operation (so I lived with it). Two years later I am diagnosed as Type 2 diabetic put on Simvastatin, Metformin, Asprin immediatly although readings 5.4. Get sent for an annual eye check up. See the Diabetic nurse 12 months later. When my HbA1c reading had gone up from 5.4 to 7. Told ok await until next annual check up. In the mean time I have seen GP about burning soles of feet and palms of hands he put me on HRT (I was 57yrs). Then in September 2011 i hurt my back, I was refered to a phisio and had acupuncture, this was going well. When my partner said your breathings funny really laboured, I'd put this down to over compensating because of my back. Saw GP sent for chest x-ray and CT Scan. I then noticed my legs and around the area above my waist but below my bust was extremely bloated, after a few days this became all over from my face down to my feet and everywhere inbetween. Went to GP sent to Hospital where admitted and put on diaretics. Heart people become involved. After several months all my organs are OK. During this time I have been on the internet found out about Lymphadema spoke to Dr about this - "oh no nothing to do with that!". As a by the way I had seen podiatrist who said i need to have both large toe nails removed as ingrowing and had, had several infections. She wrote to GP in March 2012 for permission to do this procedure. I asked him about it as had not had appointment, he checked on screen and said of had not replied did not realise he had to. So at the end of May he replied. On the 1st of June I had to see out of hours Dr as in a lot of pain on both lower legs, transpired I had Celulitus. This continued from June to September on antibiotics the whole time (2 types) until nails could be removed. It then transpires I have Peripheral Neurophathy and Lymphadima (fluid build up in the Lymphatic system) the burning in my feet and hands and now the feeling of red hot needles being poked into my feet and ankles is Puripharal Neurophathy. Not the post menopause hence the HRT that i was told it was. Now my Hba1c is high at 79, my day to day blood sugars all over the place, was unable to walk and still cannot walk very far, breathless because of fluid, having to wear support stockings and told that both cannot be cured but only treated with some reduction but not cure. So when people see their GP do not believe everything they say question and research as much as you can. Question what they suggest as far as medication is concerned and get a second opition if you are not happy. I wish I had done more of this and not taken my GPs word for everything. I now see another in the practice who explains everything and has forwarded me on for help in these areas.