Advice needed

[eddie775]

Several months ago I started getting worse symptoms of pins and needles in my feet ( I have been getting these for about a year ) , burning and pain in them when starting to walk and also period of numbness. I was also getting tired in the afternoon, nodding off sometimes when I was working on my laptop. This would often happen if I had just had something to eat. I thought about pre diabetes as I had seen things in the press, so I bought a testing kit. Since june , I have been testing in the morning when I get up, before I have my regular coffee and toast, on a fairly regular basis and the scores have been coming in between 5.9 and 6.4 mmol/l.

I went to my GP and she got blood tests done, including a HB1Ac, and when I rang back for the results I was told they were all 'normal'. She never mentioned Diabetes when I went to see her and when I called in for the results there was no mention.

I have private health insurance and because I have had prostate cancer and had surgery just over a year ago ( I am 54 years old) , I went and saw a neurologist - I had seen one last year post cancer surgery over my neck and he said to just book an apt if I had to see him again. He wanted to investigate the pins and needs and therefore had an Nerve Conduction Study done on my arms, legs and feet by a specialist neuro at another hospital. The specialist has said that everything is working within normal boundaries. He said often people report pins/needs/burning in feet and it cant be explained. He did ask me if I suffered from diabetes and I said no. I have had an mri of both Thoracic and Lumbar spine and waiting for those results.

So the question I have here, is would my GP have told me if I was in the Pre Diabetic range on those blood tests? Should I go back and ask for the actual figures?
Am seeing the consultant neurologist on 12 Aug , should I ask him to ask the GP to double check for pre -diabetes? When I put my details into the online calculators they come up with a BMI of 33.9 and a Diabetes Risk Score: 30, and the recommendations are that I should go and see my GP to be check for Diabetes. But it seems the GP isn't concerned, else she would have said something.

Thoughts anyone?

Eddie

 

[Squire Fulwood]

There have been opinions expressed that telling someone they are pre-diabetic causes them worry when there is nothing that can be done about it. For example

http://www.drbriffa.com/2014/07/18/...elling-and-treating-people-with-pre-diabetes/

The NHS says that diabetes is progressive and it's just a matter of time so don't worry, don't test etc.

On this forum, however, there is the opinion that early warning gives us a chance to do something about it. I agree with this approach.

Getting the actual Hba1c number would be good and then it is up to you to decide whether or not to worry. I just ask the receptionist for a print out of the blood test. Not all surgeries are this co-operative.

It is also my opinion that completely healthy people could learn how to eat properly and take some responsibility for their wellbeing.

The advice often given out on this forum is to get a blood sugar monitor and check occasionally to see if there are foods that raise your blood sugar to an unacceptable level. Reducing or cutting out these foods could stave off diabetes for years.

 

[Bluetit1802]

May I ask if you had chemotherapy for your cancer? I only ask because peripheral neuropathy in the feet and sometimes hands is a common side effect of the chemo drugs, and can last 12 or more months after chemo is over, even much longer than that. I had chemo last year, finishing in July 2013. Towards the end of the treatment I got the pins and needles, burning, and a numb feeling in both feet. My Oncolgist said this is very common on chemo, and that it would most likely eventually disappear. The nerves to the feet are the longest in the body, and if compromised like this they take a long time to repair themselves. I still have a numb feeling 12 months on, but the burning has gone as have the pins and needles. Since my diabetes diagnosis earlier this year I've had my feet checked, and although they feel numb to me on certain occasions, there is no loss of feeling when prodded with the stick thing. Just a thought.

 

[jack412]

Your before breakfast is ok for now, what is your before and 2hr after evening meal like?

 

[Gudrun]

Several months ago I started getting worse symptoms of pins and needles in my feet ( I have been getting these for about a year ) , burning and pain in them when starting to walk and also period of numbness. I was also getting tired in the afternoon, nodding off sometimes when I was working on my laptop. This would often happen if I had just had something to eat. I thought about pre diabetes as I had seen things in the press, so I bought a testing kit. Since june , I have been testing in the morning when I get up, before I have my regular coffee and toast, on a fairly regular basis and the scores have been coming in between 5.9 and 6.4 mmol/l.

I went to my GP and she got blood tests done, including a HB1Ac, and when I rang back for the results I was told they were all 'normal'. She never mentioned Diabetes when I went to see her and when I called in for the results there was no mention.

I have private health insurance and because I have had prostate cancer and had surgery just over a year ago ( I am 54 years old) , I went and saw a neurologist - I had seen one last year post cancer surgery over my neck and he said to just book an apt if I had to see him again. He wanted to investigate the pins and needs and therefore had an Nerve Conduction Study done on my arms, legs and feet by a specialist neuro at another hospital. The specialist has said that everything is working within normal boundaries. He said often people report pins/needs/burning in feet and it cant be explained. He did ask me if I suffered from diabetes and I said no. I have had an mri of both Thoracic and Lumbar spine and waiting for those results.

So the question I have here, is would my GP have told me if I was in the Pre Diabetic range on those blood tests? Should I go back and ask for the actual figures?
Am seeing the consultant neurologist on 12 Aug , should I ask him to ask the GP to double check for pre -diabetes? When I put my details into the online calculators they come up with a BMI of 33.9 and a Diabetes Risk Score: 30, and the recommendations are that I should go and see my GP to be check for Diabetes. But it seems the GP isn't concerned, else she would have said something.

Thoughts anyone?

Eddie

Eddie, I would agree that it is prudent to behave as though you're prediabetic, whether your GP believes this or not. The alternative would be to go on as before and a few years down the line you may (or may not) get a diagnosis of diabetes. Not all prediabetics become diabetic, but considering the possible complications that may occur if blood sugar is not controlled (blindness, amputations, etc.) it is better to act on the side of caution.

You are already doing the right thing in checking your blood on rising. It may be good also to check one and two hours after you have eaten to see if your blood sugar rises and by how much. This is a good way to test which food may be good to avoid. You might also want to keep a record on your BS levels, a kind of chart or monthly average, to see whether they rise over time. If you are prediabetic (and my readings are similar to yours; I was told that I am prediabetic) you are likely to have years to put things right. But you might as well start now to take the first step.

 

[Brunneria]

Hi,

Have a look at the video links on this page
http://www.diabetes.co.uk/forum/threads/cured.59379/page-10#post-587550

They deal with vit 12 deficiency, which is surprisingly common, and can give the symptoms you describe.

Your doctor can run a test for you, but doctors are told, in training, that vit b12 deficiency is very rare (now disproven) so they never think of testing for it.

 

[eddie775]

May I ask if you had chemotherapy for your cancer? I only ask because peripheral neuropathy in the feet and sometimes hands is a common side effect of the chemo drugs, and can last 12 or more months after chemo is over, even much longer than that. I had chemo last year, finishing in July 2013. Towards the end of the treatment I got the pins and needles, burning, and a numb feeling in both feet. My Oncolgist said this is very common on chemo, and that it would most likely eventually disappear. The nerves to the feet are the longest in the body, and if compromised like this they take a long time to repair themselves. I still have a numb feeling 12 months on, but the burning has gone as have the pins and needles. Since my diabetes diagnosis earlier this year I've had my feet checked, and although they feel numb to me on certain occasions, there is no loss of feeling when prodded with the stick thing. Just a thought.

I haven't had chemo. I had open surgery and was anemic as I lost approx. 4 litres of blood. I had to take iron tablets after I left hospital. Apart from PSA and the recent blood tests by the GP, no one has checked my bloods in the last year post recovery.

 

[eddie775]

Your before breakfast is ok for now, what is your before and 2hr after evening meal like?

I will do some testing and see.

Thanks

 

[eddie775]

Hi,

Have a look at the video links on this page
http://www.diabetes.co.uk/forum/threads/cured.59379/page-10#post-587550

They deal with vit 12 deficiency, which is surprisingly common, and can give the symptoms you describe.

Your doctor can run a test for you, but doctors are told, in training, that vit b12 deficiency is very rare (now disproven) so they never think of testing for it.

You may have struck something here - if the B12 is associated with my anemia last year post op, that could explain things, maybe?

 

[eddie775]

Eddie, I would agree that it is prudent to behave as though you're prediabetic, whether your GP believes this or not. The alternative would be to go on as before and a few years down the line you may (or may not) get a diagnosis of diabetes. Not all prediabetics become diabetic, but considering the possible complications that may occur if blood sugar is not controlled (blindness, amputations, etc.) it is better to act on the side of caution.

You are already doing the right thing in checking your blood on rising. It may be good also to check one and two hours after you have eaten to see if your blood sugar rises and by how much. This is a good way to test which food may be good to avoid. You might also want to keep a record on your BS levels, a kind of chart or monthly average, to see whether they rise over time. If you are prediabetic (and my readings are similar to yours; I was told that I am prediabetic) you are likely to have years to put things right. But you might as well start now to take the first step.

Thanks for this advice. For years I did nothing about my health, never had time to visit a doctor. The cancer shocked me and now through a support group I went to I am taking control of my body. I would rather start sorting this out earlier than leaving it until its too late. Just wish NHS doctors wouldn't treat me as if I am thick!. I will take the advice from on here and approach the surgery for those blood test results. Thanks Everyone

 

[Gudrun]

Thanks for this advice. For years I did nothing about my health, never had time to visit a doctor. The cancer shocked me and now through a support group I went to I am taking control of my body. I would rather start sorting this out earlier than leaving it until its too late. Just wish NHS doctors wouldn't treat me as if I am thick!. I will take the advice from on here and approach the surgery for those blood test results. Thanks Everyone

You will find a lot of very good (and wise) advise in this forum. Good luck, Eddie. Let us know how you get on.

 

[Brunneria]

You may have struck something here - if the B12 is associated with my anemia last year post op, that could explain things, maybe?

Certainly worth investigating.
I think the video also mentions that vit b12 is often reduced or made unuseable by general anaesthetic.

Good luck, and please come back and tell us what the blood test results are - whether you are deficient, or not. Always good to know how people are getting on.

 

[eddie775]

Certainly worth investigating.
I think the video also mentions that vit b12 is often reduced or made unuseable by general anaesthetic.

Good luck, and please come back and tell us what the blood test results are - whether you are deficient, or not. Always good to know how people are getting on.

Will do

Eddie

 

[Loobles]

There have been opinions expressed that telling someone they are pre-diabetic causes them worry when there is nothing that can be done about it. <snip>

I agree. if it was me (and it IS me) I'd like to know if I was in "The Last Chance Saloon". In fact I'd be pretty angry if my GP hadn't said anything because there's LOTS I can do to at least put off a diagnosis of T2. I think it's their responsibility to be proactive. I mean, if you smoke, they wouldn't do an X-Ray and so "it's ok, carry on smoking for now because you haven't got any tumours yet....that we can see anyway". Damage can still be done even below the threshold of being considered diabetic, so yes, I think people should now. I think THEY have the right to make their own decisions, after discussion with the doctor/DN.

On saying that, I can see that not all doctors are proactive and will say. After my first test came back in the prediabetes range I was called into the doctor to discuss the results - who just said it was borderline and I needed another test. It's gone all quiet after the second one so I'm taking it that it's normal - but I took the liberty of booking an appointment to discuss all of the test results anyway. In any case, I want the doctor to investigate my glucose tolerance, because I know that's not normal!

 

[seaspray1998]

Hi Eddie,

You are suffering from the early symptoms of neurological damage - the banner catch all term is peripheral neuropathy, and most probably small fibre neuropathy which is a subset of that, although you will need the appropriate tests to confirm if that is it, or another form of neuropathy.

You can get neuropathy after yve had treatment for cancer.

You can also get neuropathy even if yr blood sugar levels are never that consistently high - you DONT have to be fully diabetic before this happens.

I know as I am pre-diabetic AND I have small fiber neuropathy - and the symptoms that you describe are EXACTLY how it started off with me.

THE test you need above all else is the skin punch biopsy test - where they take a very small dot of skin usually from the lower part of your leg, from which they look under the microscope for any nerve damage.

A nerve conduction test will NOT show any nerve damage for this particular type of neuropathy.

The other test you should get is the thermal test where they test your reactions to hot or cold stimuli.

There is also the QST test etc.

Please note that even if the skin punch biopsy test comes up as inconclusive, it does NOT mean you dont have it, as small fibre neuropathy can be very difficult to diagose - as the small fibers intertwine with large fibers and we are talking at looking at microns.

Fire your doctor and most especially your neurologist - he of all people should know this basic knowlege and it is unforgivable that he, in particular does not know and has given ALL the appropriate tests.

Look up the American neuropathy association - they are brillient for relevant info. The UK is uttery rubbish for all of this.

Be prepared to be treated like your an attention hysterical female, while you fight to get the right diagnosis.

Also INSIST on seeing an endocrinologist regarding your poor energy levels - I finally won my battle to get to see one this week.

Please dont hesitate to call me if you would like to talk.

Regards,
Ania
Tel: 0787 817 1222

 

[kyrani99]

What is your blood pressure?

 

[eddie775]

Certainly worth investigating.
I think the video also mentions that vit b12 is often reduced or made unuseable by general anaesthetic.

Good luck, and please come back and tell us what the blood test results are - whether you are deficient, or not. Always good to know how people are getting on.

Hi All

Well , I got my blood test results from the GP surgery, I told them I needed the printout to take with me to the neuro surgeon tomorrow ( which I am ).

My HBA1c was 39 mmol/mol normal range is 20 to 42
My B12 is 312 ng/L normal range 190 to 900 ng/L
Serum Folate 6.1 ug/L normal range 2 to 19 ug/L

So taking the above into account and that I am getting regular morning bg tests of 6.3/6.4 , this does read to me that I am on verge of pre diabetes if not there already. The B12 is interesting. In the past hour I have read numerous articles on the internet where doctors in the know ensure their patients with a B12 of below 400 treat as a deficiency, in japan they treat people who are below 500. My GP has ignored mine.

I will ask the neuro surgeon tomorrow what he thinks

thanks

Eddie

 

[Brunneria]

Thank you.

Can we have an update on what he says too?

Sounds like you are making some progress, which is good!

It's my understanding that prediabetes is a fasting reading of 5.5 or above.
And remember that the HbA1c is just an average figure. It is easy to forget that there can be some unusual highs and lows that even out to make a normal figure.

I will be very interested to hear what your consultant says about the B12. And good on you for doing the extra reading and being so well informed!

Even if you don't get any joy out of your consultant, you could always use B12 supplements yourself - it won't do any harm.

 

[eddie775]

Brunneria

Well yesterday was a sad day from the perspective of my opinion of consultants in neurology. When I got cancer I had no symptoms and it was working for an American company who did a health screening that caught me and probably saved my life. Having had that scare I know my body and I know when something is not right. I now have symptoms of 'something' and yesterday I was told basically that there was nothing to be done. NCDs are clear. My MRI was clear ( apart from 2 bulges in the lumber section that may or may not cause a problem - but not in his opinion to cause the numbness and tingling and burning ). The HBA1c and B12 - having politely asked about the possibilities, I was told that I was 'over diagnosing' - then when he saw the alarm on my face, he said it wouldn't do any harm to take B12 supplements, but to go back to my GP and discuss the results. His view was that the increased HBA1c and B12, and the daily glucose checks that I am doing in the morning coming out at 6.3/6.4 wouldn't be causing these problems. His collegue who had done the NCDs said to me that lots of people get what I have got and live with it. !

I wouldn't have minded if this was a referral via the NHS system but my GP had referred my via my own private medical insurance , so this was a private consultation at my cost. Maybe this was the wrong neuro to see.

I have just spent the whole day travelling to London and back on the train and in client meetings. All the time with the symptoms mentioned and feet in pain walking between tube stations. Yes I can bear the pain/symptoms at the moment. My concern is what damage may be being done.

Really not happy, and at the moment I wish I was living in the USA, Central Europe or Japan as this would have been taken more seriously.

Will see what GP says when I go back and see her - when that happens I don't know.

best regards

Eddie

Thank you.

Can we have an update on what he says too?

Sounds like you are making some progress, which is good!

It's my understanding that prediabetes is a fasting reading of 5.5 or above.
And remember that the HbA1c is just an average figure. It is easy to forget that there can be some unusual highs and lows that even out to make a normal figure.

I will be very interested to hear what your consultant says about the B12. And good on you for doing the extra reading and being so well informed!

Even if you don't get any joy out of your consultant, you could always use B12 supplements yourself - it won't do any harm.

spective of the

 

[Brunneria]

Brunneria

Well yesterday was a sad day from the perspective of my opinion of consultants in neurology. When I got cancer I had no symptoms and it was working for an American company who did a health screening that caught me and probably saved my life. Having had that scare I know my body and I know when something is not right. I now have symptoms of 'something' and yesterday I was told basically that there was nothing to be done. NCDs are clear. My MRI was clear ( apart from 2 bulges in the lumber section that may or may not cause a problem - but not in his opinion to cause the numbness and tingling and burning ). The HBA1c and B12 - having politely asked about the possibilities, I was told that I was 'over diagnosing' - then when he saw the alarm on my face, he said it wouldn't do any harm to take B12 supplements, but to go back to my GP and discuss the results. His view was that the increased HBA1c and B12, and the daily glucose checks that I am doing in the morning coming out at 6.3/6.4 wouldn't be causing these problems. His collegue who had done the NCDs said to me that lots of people get what I have got and live with it. !

I wouldn't have minded if this was a referral via the NHS system but my GP had referred my via my own private medical insurance , so this was a private consultation at my cost. Maybe this was the wrong neuro to see.

I have just spent the whole day travelling to London and back on the train and in client meetings. All the time with the symptoms mentioned and feet in pain walking between tube stations. Yes I can bear the pain/symptoms at the moment. My concern is what damage may be being done.

Really not happy, and at the moment I wish I was living in the USA, Central Europe or Japan as this would have been taken more seriously.

Will see what GP says when I go back and see her - when that happens I don't know.

best regards

Eddie





spective of the

How frustrating. Can you get b12 injections on you private health insurance?
That may be a silly question, but I know virtually nothing about how it works.

I think I would be knocking back b12 supplements like sweets - but hopefully other people wouldn't follow that advice!

Are there any forums out there that discuss it?

And have you considerered @seaspray1998 's comments about the 'punch test'? Or have you already had that?