Help please


#1

Hello,
37 Y/O female, height:5’3 and weight:158lbs and BMI: 26.6, most of the weight in the abdomen and arms. I have the new diagnosis of Type 2 with A1c 6.3, fasting insulin: 19.6, Homa IR:6.04 indicating severe insulin resistance and C peptide: 3.3. Now my problem is in 2009 and 2014 I was pregnant with gestational diabetes and apart from that my A1C was ranging from 5.9-6.0 over the years with 1000 mg of Metformin. Last yr I realized when I walked a long distance of over 2 miles I noticed left toe drag, scratching sounds on treadmill, muscle weakness similar to foot drop. I don’t have tingling and numbness, but has cramps in my calf/thigh at night and most nights my hands and feet are very cold. I didn’t realize I was having a problem with blood sugars, may be ignorant, A1C checks were under 6.5 with one this July 6.9. I am really worried if this focal mononeuropathy of deep peroneal nerve causing the foot drop is permanent or is it reversible? I also have young kids(3) & (8) and would like to get life insurance if something were to happen to me? Will I be eligible if I have neuropathy? I think I shd see a neurologist for further follow up? Please advise if any one is in the similar boat? I am also deficient in VIt D and B12. Any good vitamins to reverse neuropathy? I saw at Costco diabetes multivitamin pack? Is that good?


#2

@Lola4 - what you’ve described is almost exactly what I experienced 31 years ago, including the muscle weakness, foot drop and cramping.

In my case it didn’t have anything to do with diabetic neuropathy, even though I’m type 1 and have been most of my life.

Diabetic neuropathy is sensory, not motor. What you’ve described sounds strikingly similar to what I have - Multifocal Motor Neuropathy

Either way you need to see a neurologist. Another possible cause is CIDP, which can cause both motor and sensory deficits


#3

Thank you Jim for your insight. It kind of makes sense coz I did Brain and spine MRI when I was traveling abroad. It showed a spot of demyelination in the Cervical spine? Could that have been the cause of Motor weakness? I am predominantly vegetarian and being on Metformin for almost 10 yrs could have depleted B12 and could have Caused loss of Myelin?
Also about 6.5 yrs ago I had sudden onset of weakness in my body, both Upper body and Lower body, walking was difficult, holding a pen to write something was difficult, even the touch of blanket on my toes was unbearable . This acute episode lasted for 2wks, then they thought possibly MS, or B12 deficiency. Some how I never had that episode reoccur (thankfully).
Now how do you take care of this neuropathy? Were you able to fix Foot drop? Please advise!! I am quite stressed and worried? Did you use any electrical stimulation and specific exercises to help it? My calf is extremely tight, stretching it is so painful I am in tears, also how was it doing exercise with foot drop? I am also concerned could I have had uncontrolled blood sugars in the last 10 yrs and may be when they did A1C once a yr it was reasonably OK?


#4

Lola - To say the nervous system is complex would be the understatement of the year. There are any number of other possible causes for your drop foot, including MS and a variety of muscular dystrophies.

I’d urge you to see your general practitioner at the very least, who can refer you to a neurologist.

In my case (MMN), the condition is chronic and there is no cure. I’ve managed to live with it for 3 decades, and have taken to using a cane the past couple of years. I am treated monthly with large does of IViG (aka Gamma Globulin), which does dampen the immune systems relentless attack on the myelin sheath of my nerve axons.


#5

If your foot issues are diabetes related then strict BG control can remedy them but it could take a couple of years. As Jim said you really do need to see a Dr. to make any determinations. Blood tests to check vitamin levels might give you the answers regarding B12 deficiency. It shouldn’t hurt to take some supplements, I’ve heard that R alpha lipoic acid helps a lot with diabetic neuropathy.


#6

Thank you Jim and Firenza for your help.