Are You At Risk For Neuropathy?

Test Triglycerides Can Predict Who’s at Risk for Neuropathy. Here is the link from Diabetes Health.

http://www.diabeteshealth.com/read/2009/05/28/6211/test-for-triglycerides-can-predict-whos-at-risk-for-neuropathy/

Aside from lowering fat in the diet and exercise, what more can be done if you should find you are at risk?

Jan, I had some neuropathy for a few years when I was having a lot of highs and lows and a roller coaster type of control. My A1c was below 6.0 but the highs and lows can eventually lead to complications even when the BG average is good. I started pumping two years ago and my control is much more stable. I no longer have those frequent highs and lows. I still have an occasional high or low but not often at all. My retinopathy has disappeared. I have no complications at this time. My answer to you question is that you need good control with a low A1c, preferably below 6.0, and ou need to avoid frequent highs and lows. The better you do in achieving those goals the less likely you will have complications. Good luck to you!

Richard

i already have it in both feet :frowning:

Very interesting - my triglycerides keep shooting up and I have sever neuropathy in both my hands and feet.

Richard, with a Type 1 child who is in puberty, you are not going to get an A1c below 6. I have had one or two, a lot in the low 6s, some in the mid 6s or high 6s, one 7.1 once. Huge glucose swings after eating (If at home, I will give more insulin than needed and “feed the IOB” to keep spike lower). At the 2 hour mark at school needs to be 200 to be in range when insulin leaves system (four and a half hours). She does not want to low carb it; rather, she is refusing to eat meat lately. Cgms, once we start it, should help. I was thinking of certain vitamins, as listed on Blood Sugar 101 website to help neuropathy. Yes, will be working on the glucose variability. Can’t really do it properly without cgms, I can tell you that. That is because when you “feed the IOB” she will go back up. So it will be 130 two hours pprndl, lots of IOB, feed 10 grams, next hour feed ten. Don’t check more than once an hour in this case so meter will read 130, 140, 110, 80 or higher but you get the idea. But after eating, even with insulin waiting, she must go higher at some point, i.e., 130, ten grams equals spike of 180, for at least some point in time, etc. Need the cgms so I can wait till she gets as low as 100 to feed insulin and keep feeding it less and less. Does this make any sense?

Dear Richard.

My triglycerides are usually right in the middle of the normal range is that good enough? I was looking at the history of my triglycerides measurements and there appears to be a correlation between poorly controlled BG and high tri suggesting that you are right in commenting that a low HA1c is necessary.

As far as diet goes I wonder if low carb diet or a low saturated fat diet is good? I think that fructose is not good since I think it metabolises to tri but is anyone out there sure of this?

I had tri below the normal range when I was on a starvation diet not sure if this is sustainable but you wonder if for those diabetics that can an occaisional fasting would be good?

I understand Jan. I have friends with very young diabetic children and I am aware that blood sugar is almost impossible to control on a regular basis for youngsters that age. As they get older they are already accustomed to the routine needed to establish better control. When that better control appears then the A1c’s improve and as young adults an A1c below 6.0 is much more likely. In the meantime just keep the control as good as you can and don’t worry. Things should turn out fine just like they did for me.

Have you joined the special diabetes site intended for parents of diabetic children?

http://www.childrenwithdiabetes.com

I had been a regular on their chat on CWD. I encountered hostility when some of the “regular” (adult parents or adult PWDs) would opine on methods our endo recommended to control BS. Recommended diabetes care for children is different in other areas of the country, Most of the regular parents were from the South or the PWDs had much looser standards. I was not on the same page as the parents from the chat. We had much lower targets, we had been told to test BS many more times a day than the older parents, we had instructions for feeding her (with lower carb counts, and encouraged regular meals/snacks instead of grazing), and overnight testing is/was encouraged, unless we could not physically handle it. I got a lot of flack for the overnight testing (parents would claim it was not necessary and felt 10 times a day was abusive) and we test 10, 12, now 15 times a day, sometimes (at that time it was 10 or 12). Encountered hostility when I was interested in cgms. However the chat and forums are two different sets of parents and the forums are EXTREMELY informative. Many parents handle D like we do, or even tighter control. Many don’t. So I turned to the real experts – the adults with D who are interested in tight control, first on blogs, then on this forum. The adults are honest and advice has not steered me in the wrong direction. I do read certain posters on CWD forums (there are a few parents who really know how to tame the D beast, though they use cgms). I do not post as I am reading a lot of hostility and fighting among parents on the board. I do not find it useful for a new parent to ask if they should feed their child carbs when their blood sugar is 395, one parent is trying to be helpful and says, no. Whereupon all the posters jump on and attack that person, saying to feed the child and “cover” for it. But they get quite nasty to the parent who advised not to feed the child; they don’t just state their opinion. DN’s endo would have an absolute FIT, and would rightfully, call us on the carpet if we ever did such a thing. So I would say the difference in philosophy regarding D management between many of the parents and how we do things is too extreme to be of much help (with the exception of those very few parents, whose posts I still look for). We do not use a low carb diet. We do exactly what the endo recommends, 180 - 225 grams a day, spread out over four meals/snacks. There are exeptions and we are flexible. But as a rule, we do not feed her 100 plus grams at one sitting. We do not encourage her to eat anything whenever and whatever her heart desires and bolus for it. Most of the parents on the forums don’t either, but some on the chat may. P.S. CWD chat parents were extremely helpful to me the first year and a half when endo had her on tight target overnight. Endo would only correct if under 80 and wanted us to bring her up to 100, so small increments of juice. This was not possible as she drops at night. At the time, my sister was trying to follow endo advice (she was working overtime and not really seeing the patterns) and I was trying to go for a higher target. Now we both do the same, bring her up to 120 and she will be 80 or lower in the morning.

Jan, I approve of what you are doing and I am amazed at some of the things yoy have said about the members on CWD. that is too bad for their children, at least that is my way of thinking. I am 69 and I test 12-15 times per day and I check twice during the night, just in case. My BG is very stable but there are times that the unexpected happens.

You remind me so much of my friend Holly in NC. Her daughter Caylin was diagnosed when she was about 1 1/2 or 2. She tests Caylin many times per day like you do and she tests a few times at night too. You would probably learn a lot from Holly. She posts on dlife.com but you have to know where to look for her. She would give you her email after she got to know you. You could use my name as a reference. I helped Holly in the past shortly after Caylin’s diagnosis. We are good friends. She calls me Dad. Lol! Let me know if you want to meet Holly online.

I have not looked on the dlife boards. Sorry the above post is negative; just my experience. I would still guide new parents to the CWD site as there is an incredible amount of information on the site itself. There are parents posting on the forums who have a lot of good information to share; you will soon learn the posters you want to “follow.” I found the chat experience negative, though I did chat for close to three years. I am always up all night until at least 3am and am always on the Internet. The only thing that would help now is cgms information (and I hope she agrees to wear it this time). I actually have 120 on her meter as a 14-day average and have kept her post-prandials down using the “over-bolus” or sometimes “over-basal” method (overbasal method is accidental as she frequently changes her basals 6pm to midnight; never intentional). But I can only use this method at home. Also, I am not sure how safe “feeding the insulin” is (without cgms to guide you) since you will certainly spike, albiet for a shorter period of time, when you feed insulin on board. I will look on dlife. I must say, though, that I have learned an enormous amounts from reading the Type 1 posts on this board. And the Type 2 posters, particularly Jenny 's information on “Bloodsugar 101”, I have gained true knowledge of how low we should aim to keep blood sugars (not in the 6s, in the 5s, if possible). If it is not safe for a Type 2 to have BS levels of 6.5, then why do they tell us that’s a good target for Type 1 children? I know it is very difficult to achieve that target, but endos should at least tell us the truth. Indeed, on the CWD board, parents are thrilled to report A1cs in the low to mid 7s, and woe betide the poster who informs them that they really should try to go lower, mid 7s are not where you should aim. It is the adults who know the disease, so I look for information from the horse’s mouth, so to speak.

I think that low to mid 7’s is OK for very young children if they have a lot of lows. If the BG is more stable (less variable) then aiming for 6.5 is much more safe and therefore desirable. How old is your daughter? I had the impression she is pre school age.

If you go to dlife then look at the list of forums and find the one labled “Parents Helping Parents”. It is not very active like CWD. If you want to connect with Holly then select the “Everything But The Kitchen Sink” forum. In that forum there is a thread usually at the top of the page “…Coffee House”… It is mostly a group of women and a few guys who gossip about their lives and their diabetes. Look it over, it may not appeal to you but if it does then you will get to know some of them and be part of the group.

My favorite diabetes site is listed below. I have over 5000 posts there and I am addicted ti it,

http://www.diabetesdaily.com

She is my niece, although I manage her D five days a week (Her Mom has the weekends, when I work long shifts). She is 12, diagnosed at 8. We have had 7.1 once or twice, high 6s when we are having trouble gaining control, but no, 7s are not where I want her to be at all. I would accept 7s if I had to, but we can usually get mid 6s and very often low 6s. Only in the high 5s a few times. I would like to remain in the low 6s, and strive for the high 5s once she is on cgms.

My triglycerides are fine, but I have polyneuropathies since I have been diabetic for 40 yrs.