Nerve damage

I have had type 1 for 37 years. I was terrible as a teenager with controlling my bg levels. I have been on an insulin pump for about 10 years and take novo rapid insulin. I have far more low bg’s than highs. I don’t know much about nerve damage. I was told by my specialist that I most likely won’t have this problem. Twice now I have awoken to my heels being numb and once I moved them around I had the pain of pins and needles. Do you think this could be nerve damage or am I just being paranoid?

It may be peripheral neuropathy and I’d recommend consulting a doctor. I had mild peripheral neuropathy symptoms within a few years of my diagnosis at the age of 30. Around year 27, following a sustained loss of good blood glucose control, I started to feel a general loss of sensation in both my lower legs/feet and my lower arms/hands.

I eventually turned dead serious with my diabetes efforts and most, but not all, of my peripheral neuropathy symptoms disappeared. A doctor can prescribe medications to help with this but I’d highly encourage you to examine your blood glucose control methods first and see if you can’t improve some of them. Relatively minor improvements in blood glucose control can have large effects on your symptoms.

Something as simple as adopting good pre-bolus practices can have a huge effect on your post-meal BGs. Do you pre-bolus? Is it a fixed time, like 15 minutes, or have you tested yourself to find out when your insulin starts to drop your BG after taking a meal-dose? That one simple technique, if implemented and followed, can really lower your overall blood exposure to glucose.

The landmark Diabetes Complications and Control Trials (Google DCCT) in the '90s showed that “intensive” blood sugar control efforts often diminished or even reversed peripheral neuropathy symptoms. The definition of intensive back in the DCCT trial is much less aggressive than what current technology enables today. My symptoms today are still mild and easy to live with. I’ve been T1D for 33+ years.

Good luck!

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I’ve had mild symptoms such as you describe for several years now. They do actually seem to respond to my degree of BG control; when control is good, the symptoms lessen noticeably.

It’s still a matter of debate and more research is needed, but there is evidence to suggest that when BG is well controlled, the body is able to repair nerve damage to some degree. This applies only to peripheral nerves, not the central nervous system.

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I have not researched this but I’m aware that Dr. Bernstein claims to have reversed the symptoms of his gastroparesis (GP). He said it took a long time, as in years, of normal blood sugars (4% A1c range) for this to happen. His n=1 report gives me hope. I have noticed that my GP symptoms have not advanced since my return to tight control five years ago and I also observe some minor improvements. I realize that anecdotes do not make science but when that n=! is you, it looks a lot more persuasive.

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Lucky for those that have GP and can control their sugars…little hard when you can’t predict when the carbs will release into your body and you are denied Pump / CGM…I had to take the hard way out…and yes, the damage that was done was able to be reversed. As I sit here writing this, I have had to stop to be sick and the 24/7 waves of nausea never end…never…sorry, lucky for some but for others like myself a pipe dream…

I am sorry to read this. It sounds very difficult to live with.

I try to write about my diabetes in such a way as to not over-generalize. The “your diabetes may vary” is a good guide. You’re right, I am lucky that my case of GP is mild, at least for now. I am grateful for that and try not to let my personal experience dominate my thinking and writing.

Thank-you for adding some balance to this issue.

Hi Terry,
You write well and I wasn’t trying to be snarky… just sometimes gets a little hard for those of us with a sever case of GP (would sell my mother-in-law to get rid of it) … I also count myself lucky that despite these conditions I get up and go to work every day because I can…the small things right.

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