New diabetes pain clinics

Diabetes pain clinics sure are popping up around town. Are we really at high risk of getting a bunch of pain from neuropathy or are these mainly just a mechanism for distributing pain meds to everyone on earth because that’s the trend? What is your intuition/experience? Someone asked me and I don’t have the answer.

After 40 years of type 1 diabetes, I started getting neuropathic pains in my feet, but then I discovered the new drug Benfotiamine, which basically concentrates B-vitamins along the nerves, and this was able to stop the pain completely. Now I just take some every day to keep the pains away. I actually helped provide a company with some research on the drug so it could be introduced in the United States and Canada, and now you can get it at almost any place they sell supplements. It was initially hoped that Benfotiamine would protect patients against all diabetes complications, but that hasn’t panned out. Still, I would rather stop neuropathic pains by improving the health of my nervous system with Benfotiamine than by suppressing the pain symptoms with a narcotic.

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How painful is neuropathy? Pretty bad? Does it feel like when your foot falls asleep, or different?

Like all things diabetes, the answer is that it depends. So let me explain.

I have had T1 for 43 years and about 25 of those were almost un or marginally controlled. I have neuropathy and it is painful but I have learned to manage using Gabapentin. If it were not working I would have been lost because the pain can be unreal.

Now my mom had diabetes in the 1960’s to 1986 and by 1967 she had horrific neuropathy. Yes, mine is bad, hers was unreal. Ok, so different day, different treatment different outcomes. I literally saw her walking around almost all night because sleeping was impossible and this went on for years. At the end of my mom’s life she had over 100 breaks in each foot and she felt nothing below her knees.

So yes it can be awful and it gets worse as the result of high blood sugar. Remember in the 60’s and most of the 70’s we put in insulin and hoped it worked because we never really knew.

So to answer the question, yes I can say if I had uncontrolled neuropathy I would be miserable and might take a chance on one of these. Thankfully my current regiment works.

Regardless your best bet is to control your blood sugar. I sought out a neurologist for help with my situation. I would suggest that before a pain clinic.

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Your comment is interesting in view of some research studies showing a familial pattern of diabetic complication inheritance, perhaps because of genetic factors influencing the development of complications. So like mother, like child.

Oh no, nothing like that. Mom was a serious mess in fairly short order. Mom was also blind and had kidney failure both as a result of diabetes. I am happy that I have not experienced anything like that. I am pleased I am in much better shape.

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You and I haven’t had the benefit of home bg testing the whole of our diabetic careers, but have seen substantial benefit from it. Benefits that weren’t available at all to someone who only lived before the 1980’s.

I’m simply horrified reading some of the stuff published by Joslin et al up through the 1970’s, especially the ones that gave rough outlines of how many years in (sometimes just a few years) until various complications were to be expected. It’s not like it’s new to me (I had a doc predicting all my complications and when they would happen to me, the same week as my diagnosis!, I think largely taken from the Joslin schedule) but only rarely am I reminded of it.

They still gave medals at 25 years back then because it was really unusual to go that far. And the diagnostics (no home bg testing, no A1C) as to why some made it that far and others didn’t, were almost completely unavailable. The medalist study only began around 2005.

I went through the Joslin’s Clinic course for new diabetics in 1966, which was taught by the occasional nurse and a few doctors from Harvard Medical School. I remember one doctor in a lecture saying the type 1 diabetics could expect to live around 30 years, while a nurse spent her entire time shrieking at us that “the thing wrong with YOU PEOPLE is that you don’t have the courage to stick the syringe in at 90 degrees!”

That said, most of what I have seen said by the medical profession to diabetics has been profoundly irritating, propagandistic misinformation, trying to convey an image of the disease as no big deal and almost certain to have a simply wonderful outcome. They should be careful, since there’s a Massachusetts statute forbidden the publication of medical misinformation.

I love the legal stuff.
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