Poor feet

[ben39uk]

Hi, I'm a 79 yo male with Type 2 since 2014 used to have pins and needles in my feet lately its started to climb up my left leg to just below the knee, (the central vein was removed for a triple heart bypass) and the soles of my feet feel like I'm walking on cardboard (difficult to explain) The nurse for my t2 check last week told me I'm now high risk because I didn't feel the bit of nylon they touch yr feet with or the tuning fork thing, but what does that mean? my last blood test 6 weeks ago I was 55 HbA1c, this week It is 48 HbA1c, (I have stopped eating tinned fruit and fresh fruit on Dr's orders) I have managed to get my weight from 21 stone to 18,10 stone. My question is if I keep dropping my HbA1c and my weight will the feeling in my feet return to normal? I'm so afraid of amputation but have no medic to talk to

 

[CatsFive]

No idea if your feet will return to normal, but continuing to get your HbA1c down and reducing your weight can only help.

 

[EllieM]

Hi @ben39uk congratulations on getting your weight and your hba1c down. That's a fantastic result.

I think the main issue with losing feeling on your feet is they become much easier to injure, and you don't necessarily notice the injury. So you need to be more careful with them (eg don't wander around the house in bare feet). So you are at higher risk of things like amputations but that definitely doesn't mean you are going to have one. Also, high blood sugars make foot injuries more likely to get infected so getting your hba1c down to 48 sounds like it will help to prevent that.

Though a lot of people say that diabetic neuropathy can't be reversed (assuming that is what you have?) there are several reports from members here who've had neuropathy and reduced it by improving their blood sugar control.

I'm going to tag @KennyA who had neuropathy symptoms when first diagnosed.

Disclaimer, not a doctor and this is definitely not medical advice.

 

[KennyA]

Hi, I'm a 79 yo male with Type 2 since 2014 used to have pins and needles in my feet lately its started to climb up my left leg to just below the knee, (the central vein was removed for a triple heart bypass) and the soles of my feet feel like I'm walking on cardboard (difficult to explain) The nurse for my t2 check last week told me I'm now high risk because I didn't feel the bit of nylon they touch yr feet with or the tuning fork thing, but what does that mean? my last blood test 6 weeks ago I was 55 HbA1c, this week It is 48 HbA1c, (I have stopped eating tinned fruit and fresh fruit on Dr's orders) I have managed to get my weight from 21 stone to 18,10 stone. My question is if I keep dropping my HbA1c and my weight will the feeling in my feet return to normal? I'm so afraid of amputation but have no medic to talk to

Hi ben

I'll try to answer your questions first. Some of the information is my own experience, the rest is taken from Bilous and Donnelly's "Handbook of Diabetes" which is a standard textbook used by the NHS.

There are basically two sorts of neuropathy - the numb and the painful. Both appear to be caused by the dying back of the longest nerves: so it's usual that this starts in the feet. It happens because high blood glucose isn't good for nerves or capillaries. I never had particularly high blood glucose so it's not direct cause and effect: some people seem to get symptoms at low levels, others run with much higher levels and stay largely symptom free.

The big risk with having numb feet is that they can become damaged and you won't feel it. There is then a risk of ulceration (which is difficult to treat at the best of times but having high blood glucose makes it more difficult) which can lead to gangrene and its consequences.

The other thing that needs to be said is that there isn't a great deal of medical information around about neuropathy: because of the common medical view that diabetes is progressive and inevitable, there isn't a lot of official advice helpful to those of us who get neuropathy. It's known and recognised, but not "well understood" to use the medical jargon for "we don't know much about it"

The good news is that there is something you can do about it.

I had painful neuropathy starting about eight years or so back. Pins and needles, burning pain especially at night, "stabbing" pains. At the time my blood glucose level was rising (although no-one had told me) and I was specifically told that I wasn't diabetic. Once diagnosed I went on a very low carb diet and reduced my HbA1c to normal levels in a few months. The neuropathy symptoms started to go almost immediately I started low carb and faded very quickly. I still get a mild tingle (this is I guess probably permanent damage) but I have had no pain and particularly no burning since early 2020. Most of my other symptoms have also gone.

You asked "if I keep dropping my HbA1c and my weight will the feeling in my feet return to normal?" So, if my experience is any guide, I'd say definitely yes, you can make big improvements with reduced blood glucose. Weight loss in itself probably won't affect your neuropathy, but will make you feel better generally. So I'd stick with no fruit, and look at reducing or eliminating other sources of carbs and sugar such as bread, pasta, potatoes, pastry, cakes, rice, etc.

Best of luck. If anything isn't clear, please keep asking questions and let us know how you get on.

Thanks for the tag @EllieM

 

[ajbod]

My neuropathy was like kennys, hot burning feet, incredibly sensitive to the slightest touch, couldn't stand the duvet on them. Sitting down would get almost electric shocks, and intermittent stabbing pains, causing leg twitches. All this virtually disappeared as my levels dropped, although feet still sensitive, but nowhere near as bad. If they get too hot, i feel a vague tingle, almost a signal. Cooling them stops it in it's tracks.

 

[LakeWoman]

Hi ben

I'll try to answer your questions first. Some of the information is my own experience, the rest is taken from Bilous and Donnelly's "Handbook of Diabetes" which is a standard textbook used by the NHS.

There are basically two sorts of neuropathy - the numb and the painful. Both appear to be caused by the dying back of the longest nerves: so it's usual that this starts in the feet. It happens because high blood glucose isn't good for nerves or capillaries. I never had particularly high blood glucose so it's not direct cause and effect: some people seem to get symptoms at low levels, others run with much higher levels and stay largely symptom free.

The big risk with having numb feet is that they can become damaged and you won't feel it. There is then a risk of ulceration (which is difficult to treat at the best of times but having high blood glucose makes it more difficult) which can lead to gangrene and its consequences.

The other thing that needs to be said is that there isn't a great deal of medical information around about neuropathy: because of the common medical view that diabetes is progressive and inevitable, there isn't a lot of official advice helpful to those of us who get neuropathy. It's known and recognised, but not "well understood" to use the medical jargon for "we don't know much about it"

The good news is that there is something you can do about it.

I had painful neuropathy starting about eight years or so back. Pins and needles, burning pain especially at night, "stabbing" pains. At the time my blood glucose level was rising (although no-one had told me) and I was specifically told that I wasn't diabetic. Once diagnosed I went on a very low carb diet and reduced my HbA1c to normal levels in a few months. The neuropathy symptoms started to go almost immediately I started low carb and faded very quickly. I still get a mild tingle (this is I guess probably permanent damage) but I have had no pain and particularly no burning since early 2020. Most of my other symptoms have also gone.

You asked "if I keep dropping my HbA1c and my weight will the feeling in my feet return to normal?" So, if my experience is any guide, I'd say definitely yes, you can make big improvements with reduced blood glucose. Weight loss in itself probably won't affect your neuropathy, but will make you feel better generally. So I'd stick with no fruit, and look at reducing or eliminating other sources of carbs and sugar such as bread, pasta, potatoes, pastry, cakes, rice, etc.

Best of luck. If anything isn't clear, please keep asking questions and let us know how you get on.

Thanks for the tag @EllieM

So very helpful this reply as I too have had neuropathy symptomns since diagnosis nearly a year ago - I've lost over 12 KG and still the symptoms are there, doctor prescribed lidocaine ointment (!) - good to know that I must continue supervigilance with low carb including cutting out fruit. Thank you.

 

[Firefly1]

I highly suggest to watch Dr. Berry and Dr. Bernstein’s videos on neuropathy. The general thought is once we stop what’s attacking the nerve, new nerves will resprout. Thought is about 1mm per day. Plenty of stories here of people who have reduced their pain and numbness. Notice, the numbness will be replaced by pain first, then pain should gradually disappear. That is the prevailing thought from those videos.

 

[Firefly1]

Let me add, the old damaged nerves are not going to be repaired, however, new nerves resprout and will replace the old nerve.

 

[Oldvatr]

Article on aunty Beeb tonight. Tingling feet can be a sign of B12 deficiency. i.e. if not actually painful, then the B vitamins may help. B12 is not found in B complex or multivits, and has to be bought as a seperate item. Brewers yeast has some B12 in small dose but is not very effective.

Ask GP for test for B12 especially if you are taking Metformin since that drug depletes B12 over time.

 

[LakeWoman]

I highly suggest to watch Dr. Berry and Dr. Bernstein’s videos on neuropathy. The general thought is once we stop what’s attacking the nerve, new nerves will resprout. Thought is about 1mm per day. Plenty of stories here of people who have reduced their pain and numbness. Notice, the numbness will be replaced by pain first, then pain should gradually disappear. That is the prevailing thought from those videos.

So encouraged to read this! Pls do you mean Dr Ken D Berry? And which Dr Bernstein do you refer?

 

[Zilsniggy]

Hi, I'm a 79 yo male with Type 2 since 2014 used to have pins and needles in my feet lately its started to climb up my left leg to just below the knee, (the central vein was removed for a triple heart bypass) and the soles of my feet feel like I'm walking on cardboard (difficult to explain) The nurse for my t2 check last week told me I'm now high risk because I didn't feel the bit of nylon they touch yr feet with or the tuning fork thing, but what does that mean? my last blood test 6 weeks ago I was 55 HbA1c, this week It is 48 HbA1c, (I have stopped eating tinned fruit and fresh fruit on Dr's orders) I have managed to get my weight from 21 stone to 18,10 stone. My question is if I keep dropping my HbA1c and my weight will the feeling in my feet return to normal? I'm so afraid of amputation but have no medic to talk to

Okay, I will be blunt. It is likely that losing sensation in the feet and what you describe, may be neuropathy(damage to the nerves caused by diabetes). This makes feeling in the feet or anywhere else you may have it very difficult, so easy to injure the feet. Hence that is why you are asked to check feet daily for any injury that could turn gangrenous and lead to amputation. The best thing to do is continue to lower your HBA1c, lose weight, and control your diabetes. I’m afraid once you have damaged a nerve, it can take a very long time to heal, if it ever does.

The fruit, both tinned and fresh, is full of fruit sugar, fructose, which affects your blood sugar the same as eating ordinary refined sugar, which is why you’ve been told to stop eating it. Tinned fruit is often canned in syrup, which also adds more sugar. Other foods in your diet will have a similar effect, breads, biscuits, cakes, cereals, drinks, alcohol like beer, cider and lager, and mixers if you drink spirits, so always try to get sugar free drinks. Even milk can raise blood sugar! If you’re not already aware, check what carbohydrates are, and try to limit them in your diet. If you have a blood sugar meter, use it to check you blood sugar around 2 hours after eating carbohydrate, and you will see the effect it has on you. Limiting the carbohydrates may also help you with your weight loss. Check out a website like Diet Doctor(free) as there is a lot of great info there. Good luck!

 

[Firefly1]

Okay, I will be blunt. It is likely that losing sensation in the feet and what you describe, may be neuropathy(damage to the nerves caused by diabetes). This makes feeling in the feet or anywhere else you may have it very difficult, so easy to injure the feet. Hence that is why you are asked to check feet daily for any injury that could turn gangrenous and lead to amputation. The best thing to do is continue to lower your HBA1c, lose weight, and control your diabetes. I’m afraid once you have damaged a nerve, it can take a very long time to heal, if it ever does.

The fruit, both tinned and fresh, is full of fruit sugar, fructose, which affects your blood sugar the same as eating ordinary refined sugar, which is why you’ve been told to stop eating it. Tinned fruit is often canned in syrup, which also adds more sugar. Other foods in your diet will have a similar effect, breads, biscuits, cakes, cereals, drinks, alcohol like beer, cider and lager, and mixers if you drink spirits, so always try to get sugar free drinks. Even milk can raise blood sugar! If you’re not already aware, check what carbohydrates are, and try to limit them in your diet. If you have a blood sugar meter, use it to check you blood sugar around 2 hours after eating carbohydrate, and you will see the effect it has on you. Limiting the carbohydrates may also help you with your weight loss. Check out a website like Diet Doctor(free) as there is a lot of great info there. Good luck!

Agree. I’ve kept my A1c at 5.4-5.5 with a diet of…fish, chicken, turkey, steak, burgers, coffee (no sugar) salads (oil and vinegar) eggs, bacon, Chobani triple zero yogurt and Almond Malk. Notice I said Malk and not milk. There is a wrap bread called Joseph’s that has 2 net carbs. That’s what I use to make wraps. If I order a wrap from a sub shop, I swap out their wrap with Joseph’s. I try to keep my net carbs between 25-30 per day. Went from 228 lbs to 172. A1c was 12.5. Eyesight seems better & kidney tests all normal. Had EMG and that was all normal. Reversing these complications is possible.

On 1 500mg Metformin per day and Dr. said I can come off. I chose to stay on.

No fruit, milk, bread, pasta, alcohol, candy, cakes, sugar, waffles or pancakes.

LCHF diet.

 

[Firefly1]

So encouraged to read this! Pls do you mean Dr Ken D Berry? And which Dr Bernstein do you refer?

Yes, Dr. Ken Berry and Dr. Richard Bernstein. They explain how both small fiber and large fiber neuropathy can be reversed. Great stuff from a scientist point of view. And very logical.

 

[Firefly1]

Yes, Dr. Ken Berry and Dr. Richard Bernstein. They explain how both small fiber and large fiber neuropathy can be reversed. Great stuff from a scientist point of view. And very logical.

Oh…and for the love of all that is holy….no ice cream.

 

[CatsFive]

Yes, Dr. Ken Berry and Dr. Richard Bernstein. They explain how both small fiber and large fiber neuropathy can be reversed. Great stuff from a scientist point of view. And very logical.

Can you summarise their advice?

 

[Firefly1]

Can you summarise their advice?

Stop eating processed foods and food high in sugar and carbs. Sugar molecules attaches to blood which bonds to nerves. I believe the term is “glycation”. Nerves don’t like that. As nerves are attacked, communication between nerves and muscles etc…is broken and/or misfires signals. This is neuropathy (injured nerves).

Both large and small fiber neuropathy. Myelin sheath of nerve is usually first to be attacked. Overtime this damage becomes permanent and may spread from toes to feet to shins and upward. Same for the upper extremities.

BUT, nerves have the ability to resprout. The new nerves will replace the damaged nerves over time perhaps as slow as 1mm per day. The taller you are, the longer it will take to heal feet.

Hard to summarize as it’s a multiple step process.