Confused and frustrated Nerves or Circulation issues ?

Hi all,

It's been a while since I have posted on the site due to some complications that have resurfaced. When I originally joined the board shortly after diagnosis I was plagued by pins and needles and cramping in my feet and legs with occasional pins and needles in my hands. After starting my metformin 1x500mg with pm meal and getting my blood sugars under control my 90 day average has never gone above 5.6 and is currently at 5.5 mmol/L, the symptoms of pins and needles subsided and I was hardly bothered by them. The distance I was able to walk improved and things seemed to be ticking along nicely.

However over the last few weeks and numerous visits to the Dr's I have been referred for some EMG tests although I disagree with the Dr that this is the most likely cause. My problem is that I have not altered my diet still hardly ever go above 6 (at 1hr post meal) something which they seem astounded by. My dietician does not want to see me any more she is happy with everything ... but then again she seemed to think that 10mmol/L 2hrs after eating certain carbs was ok (but that's another issue all together). My problem is that I think I have circulation issues rather than nerve issues. I have seen two GP's in the same practice and on Monday I had had enough of the sensations pins needles in feet, legs and hands and arms (both sides and symmetrical) My hands and feet are cold I have hardly any hair (virtually none from the knee down) on my legs but the Dr's just say my Diabetic foot check was OK and its likely to be nerve related ..... so I went to the acute clinic and explained over the last few days (fri/sat/sun) the pins and needles had woken me from sleep my hands and feet were cold and as the weather has come in colder I have started to get more frequent cramps in my calves when I walk and accompanying numbness in my thighs.

The reasoning of the Dr was it is Nerve related due to the fact I am newly(ish) diagnosed presented with neuropathy and haven't been diabetic for long and my blood glucose levels are good. I explained to her of my 8+ years of lethargy thirst weight gain (whilst eating a healthy diet) that all my fasting lvls are good and it was only because of the Oral Glucose Test that I was caught this time around as previous years testing (many times in the past) had always returned adequate readings. My meter tells me I run high when I eat the wrong foods and to the best of my knowledge due to the general increase in energy levels now via good control improvement in weight that my diabetes has been running rampart for at least 8+ years. She then checked to see if my B12 was ok and it was from my previous blood tests and backed up her case by indicating that the diabetic nurse hadn't reported any circulation issues in the feet. I think I had an ultrasound done as the nurse at the time used a small device that you could hear the whooshing sound through much like that sound associated with an ultrasound for expectant mothers.

Don't get me wrong I would love for this to be a nerve related problem than a vascular one ..(I think) but just don't see or feel as though the right course of action is being taken.

I am wondering if there are any members out there that have been down this path before and can share any words of wisdom or advice and what to look out for and what to expect. I've been told that the EMG tests will take place in the next few months and if nothing is found we will move onto the next stage of investigation.

In the meantime is there anything diet wise, exercise wise that I should be doing as I really think the Dr's are barking up the wrong tree at the moment. I can't really go in all gun's blazing demanding that they look for circualtion problems before doing the nerve tests. It just bothers me that the diagnosis of diabetes took so long (partly down to my own ignorance) and I don't want that to happen with further investigations particularly when time and treatment could be put to better use.

Absolutely any advice/opinions, exercise tips and experiences welcomed.

All the best Richard.

HI Sugarless Sue,

Good suggestion but at the moment prioir to the visit to the accute clinic on Monday I was taking just the 1x500mg Metformin. Since Monday I was given Amitriptyline which so far has had no effect on the pain just makes me drowsy and sleep ... so it helps with getting to sleep a lot. I think the Amitriptyline will take a little while to kick in as it were so still early days at the moment.

One thing that I found back when I was diagnosed is that I have to steer clear of alcohol and also caffiene as they aggrevate and make the pins and needles worse - but as I understand alcohol and caffiene have the opposite effects one is a vasodilator (alcohol at low level - becomes a vasoconstrictor at higher levels) and caffiene is a vasoconstrictor at any level. But again both can effect and interfere with nerves too. I have to add I had 8 real ale bottles over the course of an evening and night when I found out during the night and next day it caused bad pins and needles - so in that instance I guess I made alcohol a vasoconstrictor but again the Dr thought it was still a nerve related problem.

There is one other symptom I didn't mention in the original post but I did mention to the Dr which is of a personal nature but we are all adults here and this disease really does effect everything (when not controlled or undetected). Forgive me for being blunt and diving in (as it were) but during intercourse or to be exact when I get an erection the pins and needles in the feet get worse as does the numbness and tingling in the legs, but again the Dr seemed to think this is more nerve related.

I am truly stumped as to what is the root problem here my instinct and personal feeling says its origins and sensations are of a circulatory problem but the medical profession seem to think it's nerve related. I think I am just upset too at ticking along so nicely and everything falling into place and feeling 'normal' for the first time in years and then up pops another problem.

It's kind of like of like when you get told you have diabetes - YAY ! finally I have an answer to what's been making me ill and then OH! I have diabetes <insert profanity of choice here> !


Thanks for the suggestion and all the best, Richard.

Thanks for the reply Sugarless Sue,

I have had cervical neck problems in the past; two neuros for that with fusion and hardware but am pretty sure it's mainly the hands/arms back and even the chest that pain is reffered to and I also believe this is a big reason why the Dr's are insistant it's a nerve related condition along with my initial presentation with diabetes. Me on the other hand I know that type of pain and this is different but again I accept that the pain could be nerve related and present differently to previous pain :?

Hehe I've already seen two Dr's in the same practice and the accute clinic Dr so am just going to have to go along with the majority for the time being otherwise I could just keep going round the same loop :lol: The referal is there and investigations are as they say underway :!:

It's going to be a bumpy ride but no worse than others have had to endure on this board

All the best, Richard.

Hi Cugila,

Thanks for the post, Autonomic Neuropathy hadn't actually crossed my mind so thats something else to take into consideration. It is the personal experiences which I am after really and as stated (quite rightly too) not a diagnosis (I apologise if it has come across that way). I think thats the main reason I feel comfortable throwing this out to the community at large here as it's very much a shared experience and collective of people from one end of the spectrum to the other. I am just very baffled and confused at the moment ... I guess it's much like the dietary advice on offer the more I look into the neuropathy and vascular implications .... you *shrug* just get so much conflicting information. Experience on this board showed me the way to a better diet which to be honest runs very contrary to the advice on offer and given at every opportunity by the dietician, GP's and other health care professionals.

With reference to my dialy numbers I check regularly before and after meals and immediately in the morning and recently last thing at night. I hardly ever go above 6 even post 1hr and am always a few points lower at the 2hr mark if not into the high 4's. With looking at all the options on this site and also the advice on excercise pretty much everything fell into place after 1-2 weeks numbers just came tumbling down and the pins and needles subsided. You see thats the baffling thing my bs when I test are fine even when the pins and needles are at their worst ! :? (on the worst day I tested *VERY* regularly never moved from my lowest 4.6 to 5.9) What do I eat well Quorn (Chicken fillets, mince, sausages), eggs, meat, homemade burgers, fish, prawns (seafood in general), sprouts, cabbage, green beans, lettuce/salad, cheese, green teas no artificial sweetners or sugar definately no bread, pasta or rice. I can get away with the odd portion of brown rice takes me into the low 6's if I want a treat. I've even found that the discovery Chilli and Taco Mix you get say at Morrisons is fine but the Fajita Mix (either has starch or sugar in can't remember off hand which) sends my numbers too high. :mrgreen: Anyway I digress

All the best Richard.

By the way I don't eat that all at once :lol: I leave a good few minutes between moving on from the last to the next food item :mrgreen: