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Thread: Diabetic neuropathy.

  1. #1
    Boolit Master
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    Diabetic neuropathy.

    I have been slowly developing diabetes for a while now. Routine blood test a few months back revealed my A1C at 6.9, not terrible yet but not good either. Dr. said change diet, exercise and loose some weight. These I have done and my glucose still averages around 230 or so.
    Now for the problem. The main reason for the blood work was severe burning on the tops of my toes, especially at night. When my toes touch the sheets it feels like a propane torch burning the tops of toes and I'm constantly jerking my toes away and lie awake most nights.
    I have an appt later this week and expect to be started on metformin.

    I have tried all the otc pain relievers, topical creams including 2 old goats, capcasiam, lidocaine creams and most diabetic nerve creams. Nothing helps. Even try to wear socks to bed some nights.
    Anyone else have these problems and or solutions?
    Life is so much better with dogs!

  2. #2
    Boolit Bub
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    i have fought diabetes and kidney failure fer a while now. had the same thing with my feet and toes. a drug called gabapentin has sure helped me. ask your doc about it. my doc put me on one 300 mg. pill a day to start. after i showed no bad reactions to that dose for a month she uped the dose to 3 300 mg. pills a day. it has really helped my foot pain and tingling out a lot.hope this helps you out some.( i wish my a1c was 6.9!!) best wishes.

  3. #3
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    Lyrica is refined gabapentin and has fewer side effects. If your insurance will cover it it works better.

  4. #4
    Boolit Master
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    Quote Originally Posted by ozarkhillbilly49 View Post
    i have fought diabetes and kidney failure fer a while now. had the same thing with my feet and toes. a drug called gabapentin has sure helped me. ask your doc about it. my doc put me on one 300 mg. pill a day to start. after i showed no bad reactions to that dose for a month she uped the dose to 3 300 mg. pills a day. it has really helped my foot pain and tingling out a lot.hope this helps you out some.( i wish my a1c was 6.9!!) best wishes.
    Oops, I forgot to mention gabapentin. I take 2 pills before bed. Doesn't help much.
    Life is so much better with dogs!

  5. #5
    Boolit Buddy PaulG67's Avatar
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    I also take gabapentin but I must use it 2 pills three times a day. It works ok, not great, but good enough.
    Paul G


    I am Retired, I was tired yesterday and I am tired today!!!

  6. #6
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    If your BS is running around 230, you need to change your diet more. Eliminate most of your carbs, and eat more beans, and see what that does. The best advice I think I've gotten since I was diagnosed was from my GP who is also a bit of a diabetes specialist. He told me that the endocrine system, which the pancreas is part of, is a very large and complex and interrelated system, and some diabetics can eat things other diabetics cannot, and we don't really understand just why this is, but it's been noted a long time. He advised me to use my tester a LOT, and let THAT tell me what I can eat and what I can't.

    One other really big factor for most of us is soft drinks. You need to eliminate ALL of them if you possibly can. I can no longer drink anything with caffiene in it. I drink mostly fruit juices and water, and unsweetened decaf iced tea. This isn't what you want to hear, I know, but it beats the devil out of "We're going to have to amputate your foot!"

    I have a friend who was on insulin for 20+ years, and he used it to eat just like he wanted, and he wanted lots of potatoes, grits, biscuits, bread, sandwiches, and lots and lots of sweet iced tea. Now, he's fighting to keep his feet and legs, and can barely stand up! And he'll tell you he knows it's because he thought he could get away with using the insulin like he did, to eat what he wanted, and ignore the doc's warnings. Didn't work out for him too well, and it won't work out for you and me if we won't do what we need to do. It's really, really tough, but it's doable, and you can't believe how eating right will change your life for the better. I've seen it too many times. An old man who was the father of an old high school classmate was a contractor and building supply owner. Had 11 kids, and was as jovial and likable as any man you'll ever meet. He became diabetic, and refused to eat right, and told the doc that if he couldn't eat like he wanted, life wouldn't be worth living, so .... he ate like he'd always eaten all his life, with plenty of biscuits, bread, potatoes and all manner of other starches and sugars. He finally started losing his toes, and then his feet, then his forelegs, then his thighs, and when he was a stump in a wheel chair, FINALLY said, "I wish I'd done different."

    You can determine much of your own destiny. It's difficult, and sometimes not very fun. Sometimes, I think I could kill for one biscuit! But I've come to leave them alone. Now, I think I may well get more satisfaction watching someone I love eat and relish one, than I ever did stuffing them down my own throat! That may sound contrived, but it really isn't for a guy who's always loved to eat, and has had superlative cooks all his life. Things just aren't always what we think they are, or what we want them to be. How we handle that determines much of how our lives go.

    Let your meter be your iron-fast guide, and believe what it tells you. It's your best friend, whether you realize it or not. Do your dead level best to keep your BS at 150 or lower, if you can. You'll feel bad for a while, but your body will adjust to this over about 90 days, and you'll start feeling a LOT better. Maybe not 16 again, but the best you're destined to feel. BUT .... you DO have to get through that 90 days, or maybe in some instances a little more. But it'll come. Faith and trust are the keys to making it there. Faith that your docs aren't lying to you, and trust that it'll work out for you like it does for most all diabetics that have "been there and done that." Good luck to you. And more than that, courage and firmness to you. You'll need them all.

  7. #7
    Boolit Master
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    Quote Originally Posted by Blackwater View Post
    If your BS is running around 230, you need to change your diet more. Eliminate most of your carbs, and eat more beans, and see what that does. The best advice I think I've gotten since I was diagnosed was from my GP who is also a bit of a diabetes specialist. He told me that the endocrine system, which the pancreas is part of, is a very large and complex and interrelated system, and some diabetics can eat things other diabetics cannot, and we don't really understand just why this is, but it's been noted a long time. He advised me to use my tester a LOT, and let THAT tell me what I can eat and what I can't.

    One other really big factor for most of us is soft drinks. You need to eliminate ALL of them if you possibly can. I can no longer drink anything with caffiene in it. I drink mostly fruit juices and water, and unsweetened decaf iced tea. This isn't what you want to hear, I know, but it beats the devil out of "We're going to have to amputate your foot!"

    I have a friend who was on insulin for 20+ years, and he used it to eat just like he wanted, and he wanted lots of potatoes, grits, biscuits, bread, sandwiches, and lots and lots of sweet iced tea. Now, he's fighting to keep his feet and legs, and can barely stand up! And he'll tell you he knows it's because he thought he could get away with using the insulin like he did, to eat what he wanted, and ignore the doc's warnings. Didn't work out for him too well, and it won't work out for you and me if we won't do what we need to do. It's really, really tough, but it's doable, and you can't believe how eating right will change your life for the better. I've seen it too many times. An old man who was the father of an old high school classmate was a contractor and building supply owner. Had 11 kids, and was as jovial and likable as any man you'll ever meet. He became diabetic, and refused to eat right, and told the doc that if he couldn't eat like he wanted, life wouldn't be worth living, so .... he ate like he'd always eaten all his life, with plenty of biscuits, bread, potatoes and all manner of other starches and sugars. He finally started losing his toes, and then his feet, then his forelegs, then his thighs, and when he was a stump in a wheel chair, FINALLY said, "I wish I'd done different."

    You can determine much of your own destiny. It's difficult, and sometimes not very fun. Sometimes, I think I could kill for one biscuit! But I've come to leave them alone. Now, I think I may well get more satisfaction watching someone I love eat and relish one, than I ever did stuffing them down my own throat! That may sound contrived, but it really isn't for a guy who's always loved to eat, and has had superlative cooks all his life. Things just aren't always what we think they are, or what we want them to be. How we handle that determines much of how our lives go.

    Let your meter be your iron-fast guide, and believe what it tells you. It's your best friend, whether you realize it or not. Do your dead level best to keep your BS at 150 or lower, if you can. You'll feel bad for a while, but your body will adjust to this over about 90 days, and you'll start feeling a LOT better. Maybe not 16 again, but the best you're destined to feel. BUT .... you DO have to get through that 90 days, or maybe in some instances a little more. But it'll come. Faith and trust are the keys to making it there. Faith that your docs aren't lying to you, and trust that it'll work out for you like it does for most all diabetics that have "been there and done that." Good luck to you. And more than that, courage and firmness to you. You'll need them all.
    Thanks for the advise.
    Sodas I never drink. Sweet tea is my kryptonite that I have to beat!
    Other than tea I can do without most sweets. Breads are another thing I dearly love but I haven't had much trouble cutting out the carbs.
    Caffeine? I didn't know it bothered blood sugar.
    Life is so much better with dogs!

  8. #8
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    Be leary of the gabapentin. It can make you a little fuzzy. Or cloudy. If you can relate. Cymbalta worked better for me than Lyrica. I had to be taken off of the gabapentin because I was passing out when I stood up.

    Stay away from anything fried. Breads or toast or breading of any type. Once you fry it it changes to a different type of carb that is more potent.

  9. #9
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    Doesn't bother blood sugar, but being diabetic makes you more susceptible to things that caffiene does not play well with. The only time I'll let myself have a Coke is when I drink alcohol. I can't drink beer because of the yeast in it (kidneys/bladder situation), so I drink only distilled spirits, and very little of that. But I've learned to enjoy one drink as much or more than I used to enjoy 4. I think the "forbidden fruit" thing makes it sweeter?

    I also have serious kidney issues and other stuff, so you have a little more lattitude than I do. But do NOT take that as free rein to eat what you want. One old friend in his 80's now has been diabetic for over 25 years, and the old time doc back then told him to just cut down on how MUCH he ate, and he's still going pretty darn strong for 80. Much of our problems we face with our health today is more from over-doing and just being libertines at the table, and some from all the preservatives and other stuff we put in our prepared foods these days. Eating less means we get fewer and less "poisons" in us, and that's always a good thing. But it's surely no "pic nic" changing our habits! It's like pulling teeth for most of us, and I'm as much a creature of habit as anyone I know, so it's really been tough for me.

    Waking up in a hospital bed, not remembering anything, and being told I'd come VERY close to dying kind'a motivated me, and made the price for being willful pretty crystal clear to me, and yet, it was STILL like pulling teeth to change my ways. Being weak early on and not wanting to eat much helped, but that wore off quickly, and ... well, it's a daily challenge. One "secret" to sustaining it for the long haul is to let yourself eat something forbidden once a month. Start off with only one thing a week, so you'll be able to acclimate yourself to this kind of diet. The body doesn't like sudden changes in what we give it to sustain itself and keep on ticking. But doing it progressively and incrementally IS more challenging. What can I say? Life's tough sometimes, and when we meet those times, we have to be tough enough to deal with it appropriately. Of all the things I hate, I think developing character is the one I resist and hate most! But it pays off. Otherwise, I'd probably be dead already! And I like this world. God gave me a life to tender and respect. I've been awfully willful with mine in many ways, but when one gets a knock on one's door THAT loud, only a fool ignores it. And it DOES get better. It's hard to keep that in mind when you're changing your ways and attitude, but it's there, waiting for you if you'll just do what it takes to get you there.

    That neuropathy is NOT a good sign! It calls for some pretty serious changes. I'm not a doc, but that's what I've come to "know" about it so far. God bless and keep you, and steady you.

  10. #10
    Boolit Master
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    Had an adverse reaction to lyrica. Was picking up tree branches and putting them in a towable cart. felt like a drunk and unsteady on the feet. Take 2 gabapentin before going to bed sleep better also have sleep apnea and use a cpap. Frank

  11. #11
    Boolit Grand Master Artful's Avatar
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    Have you seen a podiatrist? My Diabetic wife had some issues and they put her in a study
    with a cream to be put on her feet twice a day - after the study was over she noticed she was back to having problems so she asked what it was (Clonidine).
    https://en.wikipedia.org/wiki/Clonidine
    It has also been successfully used topically in a clinical trial as a treatment for diabetic neuropathy.[32]

    Campbell, CM; Kipnes, MS; Stouch, BC; Brady, KL; Kelly, M; Schmidt, WK; Petersen, KL; Rowbotham, MC; Campbell, JN (September 2012). "Randomized control trial of topical clonidine for treatment of painful diabetic neuropathy". Pain. 153 (9): 1815–1823. doi:10.1016/j.pain.2012.04.014. PMC 3413770.PMID 22683276.
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  12. #12
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    What kind of caloric intake and carb intake do you have on a daily basis? I understand that you are changing your diet, but to what? Has your GP provided you with basic meal planning information and calorie guides? If not, these links might help.
    http://www.diabetes.org/food-and-fit...hat-can-i-eat/
    http://www.diabetes.org/food-and-fit...lthy-diet.html

    Have you had your c-peptide checked to see how your actual insulin production is going?

    Gabapentin is the old go to for treatment, but the trials have shown limited efficacy with painful diabetic neuropathy. Some Docs will rx TCAs, and even anticonvulsants like pregabalin and valproate have been shown to be more effective than gabapentin.

    Make sure you keep a good eye on your feet...check them daily as your immune response it lessened when you are diabetic. You're also at higher risk for numerous other systemic issues.

    As for metformin, it isn't a great drug, but folks are used to prescribing it. There are other, newer classes that are "cleaner" drugs that may be beneficial to you. Farxiga comes to mind(SGLT2 Inhibitor), and then some of the GLP-1receptor agonist drugs as well.

    Lots of options, lots of info, and hopefully you have a PCP that is willing to try new approaches rather than just the old fallbacks.

  13. #13
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    My endocrinologist has been trying all the new "Buck Rogers new and improved" meds to lower my A1 C level (6.7) lower. The latest is Janova (SP) 1 a day. Lots of burping and flatuance with it. A 90 day supply cost me $50 co-pay. Otherwise it would cost $1200.00! He tried the "Super Injections" of Trulicity and Tanzium. I had all the major bad side effects with these, vomiting and bad diarrhea. I`ve about run out of things to modify in my diet and life style. I`ve had lower leg (from knees down) diabetic neurophy for the last 20 odd years. I have an unsteady gait walk due to not feeling my feet. I had to learn all over again back then on how to drive vehicles with this condition. I take gabapentin as well as metformin and 2 blood thinners besides insulin and 4 other pills that I`ve forgotten what they do for me and low dose aspirin in the morning. I`ve had 3 heart cath procedures in the last 2 years along with 3 stents being implanted. I`m fighting the grim reaper as best I can, but there are times I believe he may be winning.Robert

  14. #14
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    What Blackwater said. Get a meter and test test test. There are the general rules of what to eat and there are the rules for just you. I have found I can eat sweets (in limited amounts) at breakfast and lunch when I am active, but never at supper. I can eat potatoes, but not bread or rice. I take Metformin and Bydureon and my A1c runs 5.6 to 5.8 . When I get steroid shots for my back and neck I have to take Insulin to keep my glucose down.
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  15. #15
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    Know your physiology - and the only way to do that is to test your blood sugar, but in a thoughtful and knowing way. Fasting blood sugar is first thing in the AM before you have eaten/drunk anything but water. This AM mine was 104. This should be under 125, over 125 and you are doing damage to your body. Post paradinal blood sugar is taken two hours after you have eaten, with a finger prick. This should be under 190.

    You have to count and manage the number of carbohydrates you consume, of all types, eaten and drunk. My coffee is black, no carbs. You should limit yourself to 45grams of carbs per meal and half of that between meals, no more. This means you need to know both serving size and amount of carbs in everything you eat/drink, and in most cases that information is on the package. This is critical information, and if you don't know, look it up. We enjoy avocados, but there is no packaging info. Google says four grams of carbs per, but nine grams of fat.

    Between learning what you eat in terms of carb load, the time you eat, and your blood sugar, you can learn how your body handles carbs. It takes time, it is a learning paradigm at first, then a maintenance paradigm.

    There is a lot of information on line - and one of the California Universities has a complete diabetic education class on line. If you haven't taken the local diabetic education class, do it! Your MD will prescribe it and your insurance will pay for it. It is hours of information overload - take someone with you, especially if they cook for you.

    Yes, I am a Psychologist, I am diabetic, and I am controlled currently with diet and exercise.
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  16. #16
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    A drug that I haven't seen mentioned by name is Jardiance.

    I've been on metformin for several years and it wasn't doing much, even with the diet change and eating very few starches. I couldn't seem to keep it below 200 on the morning/resting blood test.

    I talked to my doctor about it and he just kept increasing the metformin, from 500mg once a day, to 500mg twice a day, to 1000mg in the am and 500mg in the pm, to 1000 twice a day. No noticeable change in the the bs.

    By chance, I was having and episode that had me worried. My sugar wouldn't come down below 300. I called the clinic and my doctor was out that day and they referred me to a different doctor.

    I spoke with him, and we talked for a good 10-20 minutes and he put me a sample pack of Jardiance and told me to take 500mg of metformin before bed.

    My A1C this day was 13

    I took the Jardiance sample pack, the first day I urinated for about 12 hours. I'm pretty sure that number is accurate.

    On the 5th day, I woke up, took my sugar, and freaked out. My sugar was 72. It had never been that low and I called the clinic to make sure that I wasn't going to die.

    Now, after about 6-8 months on Jardiance, my sugar is typically under 120, and the last A1C was 7.1.

    I know the A1C is still a bit high, but the doc caught me about a week after Thanksgiving and breaking my diet rules.


    I can't speak highly enough of Jardiance. I read about all of the side effects and, fortunately, I haven't had any of the major ones.
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  17. #17
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    See a good nutritionist. It will cut that learning curve way down. My wife helps people every day, lots have gotten plumb off their meds. May not be able to quit yours but shuld help a lot.

  18. #18
    Boolit Grand Master in Remembrance


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    This may help some of you out there wishing to keep track of your A1c
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  19. #19
    Boolit Master


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    Folks who are that high as in over 125 or so fasting need better help. You are in trouble and what you are doing is not working. Try and keep the 2hr after meals under 180 is golden but take work in the diet.

    Metformin alone did not help mine in fact it made me sick at 2000mg a day had to drop back to 500 per day. I also use long acting insulin. My original Dr surprised me 3 years ago and said sorry I dropped the ball you are diabetic.

    Needless to say I got a new Dr, in 1 year I got regulated to a 6.1 A1C My fasting runs from 80-120 fasting. it has taken nutritional courses to change my diet. My New DR.'s feel I was untreated for about 8-9 years and was within 6-12 months of going blind.

    However the damage has been done my eyes affected badly with the retinas endemic and much growth of new blood vessels. For 1 year each eye took a$2000.00 shot of Lucienta to the retina and laser surgery. My right ey responded well and vision is 20/25. The left however is not still needs more laser and shots every month.

    The numbness and burning in my feet and hand is nothing compared to going blind.

    DO Not mess with this disease get a specialist, measure every meal and morning and night. Learn what YOU can eat and what not to eat. Exercise will help but in my case with severe disabling arthritis it doesn't do much for what I can do.

  20. #20
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    It ain't easy folks.

    Listen, my health is fine. I am blessed to be healthy and strong. BUT it has NOT come without effort.
    I exercise.
    I don't drink a soda EVER.
    Coffee has 1/2 teaspoon sugar, and only drink 3 small cups a day.
    Our vegetables are organic and home grown.
    The burger is free range Texas Longhorn steer.
    The chickens are without hormones and free range.
    Our protein is raised within a mile of here and while not organic, it is certainly chemical free.
    I don't do fried foods.
    No bread.
    You CAN eat well and healthily. It just takes effort.
    It wasn't easy but it can be done. I let myself go every once in a while and have some fried oysters or clams. The price? Screaming heartburn.
    You only get one go round here. Make it count.
    Collector and shooter of guns and other items that require a tax stamp, Lead and brass scrounger. Never too much brass, lead or components in inventory! Always looking to win beauty contests with my reloads.

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