Beginning of Neuropathy?

Hi, I have been type 1 diabetic since last 28 months currently on MDI scheme using Humalog and Tresiba. My HBA1c is varying from the beginning 15.4 to 7.1, 6.1, 8.4, 7.8 and now 5.9. Recently I noticed a black spot under the skin above toe-nail. There was no pain, not even a skin sensation. I guess blood circulation was not good in that area. I told my endo he said, there is nothing to worry though he checked feets closely for the first time. He also asked me to go through 3 tests. Ankle brachial index was 0.91, Biothesiometry study gave average of 6 all over both the feet bottoms. Another Podo I Mat report was normal. There were few blisters also in forearm and inner thighs. Those may be due to hot weather and unusual dry skin.

I am curious that is it a beginning of neuropathy and I should see podiatrist for this issue. Or I can just be little more careful about feet and this black spot will go away by itself. Also I am not sure whether I am type 1 or LADA or Mody as my endo said it is not very important to get exact diagnosis, treatment is all that matters. I have been using insulin since diagnosis. Every time I ask him about the exact diagnosis he will not listen. There was one another endo I met once, he said “without a doudt you are type 1. I can tell just by looking at you”. No test, nothing.

I don’t know about the black spot, but I can tell you that type 1.5,or LADA, is type 1. Mody is another type of d, it is relatively rare, and considering your a1c has gone down to 5.9, I’d be confident you are a type1 LADA.

excellent a1c, good job!!!

I don’t think that neuropathy has physical symptoms, blotches or whatever, as it’s associated with nerves and poor circulation. I’m not sure about the black spot. What the endo is looking at are specific nerve and circulation tests which, if you pass, is good.

If you are apprehensive about the blotches, and your feet, I would recommend seeing a podiatrist. I had a situation in maybe 2010, the first time I pushed my distance running out to > 30 miles/ week. . I had a staycation and used the opportunity to run a lot. It felt great except…it was January in Chicago, so the last day I wore 2x pairs of socks and one of my toes got quite red and puffy around the nail, with some blackish goo which, of course, was totally alarming. I went to the Immediate care and everyone was extremely supportive of my having gone there and really nice about it. They rx’ed what they described as “really strong” antibiotics and referred me to a podiatrist who took the nail off and it cleared right up. He rx’ed shoe fitting and I discovered my feet had grown and started running in bigger shoes too.

1 Like

black spot and neuropathy? I think not. have you google diabetic neuropathy yet?

Thanks, 5.9 is in good range for now although its been fluctuating. I too think
I may have LADA type 1. I have to test for antibodies panel for exact

Thanks for your points, I may be in the similar situation right now. I will see podiatrist for this, just to make sure everything is ok. Actually I am also cycling a lot from last month. It helped in blood sugar control so I continued but it seems that excessive cycling has caused some trouble for feets. And that caused black, brownish skin above toenail. I was surprised that doc said its nothing to worry about. May be its not starting of neuropathy,but this spot is there for a month now. So I should anyway see podiatrist.

I googled actually, there is a lot of information there, there is a list of symptomps, black spot term was not one of them. But I didnt know all the terms they used. So I wasn’t sure.

1 Like

For neuropathy ( I have it all over–not just legs or feet), I have to use Lyrica to stay sane. 3x a day and it is expensive!

Black toe - got it once just from wearing socks that were apparently too tight. Lost the toe nails but they grew back. Probably not neuropathy. That is more of a sensation kind of complication at first.

Regarding spots under toenails: please see your doctor ASAP. While it is unlikely that this is the cause, malignant melanoma can sometimes present in this manner. Better safe than sorry, especially when it comes to malignant melanoma!