I would agree with you that we all vary as individuals. Some of us may well get neuropathy even with good blood sugar control and others seem totally resistant to the ravages of blood sugar. But we we have to also admit that there is compelling evidence that maintaining better blood sugar control reduces complication rates (including neuropathy). The DCCT trial more than two decades ago using a randomized controlled intervention trial (the gold standard for scientific evidence) demonstrated that this was true. I think we all need to be cautious about thinking that our own observations trump evidence. You wouldn't believe that just because you drive your car at 150 mph and haven't had an accident means that you aren't risking an accident. And you should carefully consider whether running your blood sugar higher doesn't also place you at greater risk.
Trenia, I see you are taking 700mg of ALA, I hope you are taking the necessary biotin as they work together. As an example, I take R-ALA (twice as effective) and it is 750mcg. biotin to 100 R-ALA.I take a total of 700-800 R-ALA per day, 2 prior to each meal and 2 at bedtime.
thank you I take all 700 alpha Lipoic acid in the morning , 1/2 h before breakfast,and Milgamma 100 - Benfothiaminum, Pyridoxini hydrochloridum - but still have pains and burning. I take Mg and K so I have to take them later in the afternoon , as Alpha reduce minerals.It doesn't help- pains and burning are the same.There is no R-ALA in my country. I think to change program and try to take B12 instead of all that.
thank you very much for your post.Most appreciate it. I exercise a lot , BS is under 120 always except 1 hour after the meal.( maybe it is individual and it is too high for me?) I suspected that it must be another reason for neuropathy than high BS as we all monitor it and are active.Maybe High BP or tension? I will try B12 (instead of Alpha and Milagamma which have no effect)
what country are you from?
you need something better than the cheap version of alpha lipoic acid
you can always order it online like on ebay.com or vitacost.com or iherb.com
thank you for the link and valuable help. Most appreciated. I had no idea where to find R-Ala. I come from Poland but we import Thiogamma(lipoic) from Germany and have no R-ala .wish you the best.
Coming in a little late on this...
Red, the hard news is improvement may not be seen for as long as 6 months to a year. And the improvement is gradual over that time span, so it can easily be missed.
As you noted in your OP, it is very very likely to get worse before it gets better when you consistently get your sugars under control. There's not much in the way of hard data about this, but there is plenty of theory -- basically, the idea is that as they nerves start to heal and "reawaken", there some spurious random firing that settles down but at first signals phantom pain.
It's like they choke and gasp on their way out, and then sputtle and gasp on their way back :-)
The peripheral nerves will take the longest (feet, hands). My own experience: After getting control from a1c 11 to a1c 6 and keep fasting sugars under 120, post meal spikes under 140 as much as possible, it too 9 months before I kind of off-hand noticed that feeling was back, and hey, I'm not being bothered every night before bed with tingling, pin-needles, etc.
Like I said, it takes a long time, and the improvement doesn't present as some sudden change. Rather, after a good 6-12 months of consistent excellent control, you'll just notice that it's gotten better -- hopefully a lot better.
Trenia, the 140 benchmark is, in tight-control land, the target ceiling for post-meal peaks.
As a T2, the only way I've ever been able to achieve this is by starting in the 80s-90s.
Start at 120, and you'll almost certainly spike well above 140. And the body, from the standpoint of glucotoxicity doesn't care what the delta is (i.e. where you started from), it only cares about the absolute level.
So, in addition to all the other various tactics I use to keep down in the healthy range, holding off eating until I'm <=90 is one of them. Of course, I'm an insulin-using T2, so I have that in my arsenal to get the BG down. Before I started using insulin, it was a waiting/exercise game when confronted with that situation (which was almost every meal).
thank you for replying, I will be sticking to the program.
do you still have any burning?
How bad was your neuropathy?
besides veggies and fruits, are healthy fats (cheese, yogurt, Butter, almond butter) better to eat than starchy carbs?
Trenia, I'm a bit confused by your post, so please forgive me if I've misunderstood anything.
I think you've mistaken some info here on TuD. It is most certainly not damaging to have BG's down to 80, and in the vast vast majority of cases, down to 70 or as low as 60. The key word here is "damaging".
Most non-diabetics have BG in the 80's, almost all the time. Some have such well-functioning BG metabolism that no matter what they eat, flooding their blood with glucose, their serum BG still doesn't leave the 80s or 90s.
I would urge you to set you fasting goal to <100mg/dl. 110 is fine, but it's a tough starting point when you eat. Problem is, you will almost always go over the magic 140 where toxicity is thought to begin, and virtually always get much higher -- like 180 or even 200+, where toxicity is certain.
Start at 80, and a meal that would be giving you some anxiety staying over 140 for 3-4 hours and peaking at 170 starting at 110 would, more or less, never exceed 140.
Everyone understands that keeping fast BG under 120 is pretty "safe". What is far too often missed is the fasting BG is the baseline for any rise due to food, and that must be considered as well.
Work to get your pre-meal BG as low as possible toward 80.
dear dave, I forgot to ask you.
what kinds of foods do you eat?
how many carbs do you eat per day?
thank you Dave for your help. Sorry for a trouble, I am foreigner and that might be a problem to understand. now I have 100-110 in the morning and after 2 h after meals 100-120. I have no meds, but illness is progressing . I am seeing a doctor in a week.
fasting 80-100 but preferbally in the 80s
after meals no more than 120
nerve damage starts at 140, stay away from it.
your gastroparesis (diabetic diareha) will do much better in the normal range
maximum dosage for alpha lipoic acid is 1800mg per day
maximum dosage for R alpha lipic acid is 900mg per day
Trenia, no need to apologize, we're all equals here!
Those numbers are great! Keep up the good work. I hope you can keep good control like this as long as possible without medications.
My advice, for what it's worth, would be to start on meal-time fast acting insulin when the day comes that your doctor -- a long with you because you've been so actively managing your diabetes :-) -- decide that diet/exercise is no longer sufficient to control your blood sugar.
There are other alternatives (i.e. oral medications), and they are much more convenient and easier to use. However there are many issues with pancreatic stimulants (like sulfonylureas) that many of us feel are not worth the risk.
Again, great job on your control!
Sorry for the tardy reply -- somehow I missed your responses!
The neuropathy got to the point where I had the following persistent symptoms:
- Chronic numbness in some fingertips and bottoms of feet
- pins & needles on bottoms of feet most of the time, on and off, while lying on the bed
- occasional burning on feet bottoms
- chronic ulnar nerve issues with right hand. Pinkie and pinkie side of ring finger were almost always completely numb -- no touch sensation at all
- Something that sure seemed like arthritis in both pinkies, knuckle and second to last joint; this went on for 1.5 - 2 years while I was totally out of control
- Hypertension -- was running as high as 170/140 during the bad times, but treatment-justifying high BP every time I was seen. After about 3 months of tight control, my BP dropped to 118/70, and has stayed there (I was more excited about this improvement than any other)
- Digestive issues -- chronic IBS-like symptoms... all gone
- Dizziness, hypersensitivity to stress and anxiety -- it didn't take much to get dizzy, have a feeling like a fist inside my head, unable to process and think; all much better with tight control
Also, as we all know, everyone's different. I'm banking this one away as my maybe one genetic plus with all the genetic negatives I've got that gave me this disease in the first place.
Best of luck to you Red Baron, and I really hope your symptoms improve!
I'm too lazy when it comes to food prep to serve as an example for others. I focus far more on simply low-carbing, and doing my best to balance nutrition with what I eat.
There are days when I have a really good salad for lunch, with chicken breast meat, for example, others where I'll have an In-n-Out Double Double. Never fries though :-)
I keep myself under 100g carb a day, shooting for 60-70, some days going over 100 when there's a good reason to (like celebrating a birthday out to dinner -- all bets are off then!)
Red, have you done a BG testing "study" on yourself for a day to see in detail what you BG looks like through the day? Easiest way is to borrow a CGM from your doctor (or get one!). Absent that, spend a day doing everything normally, but take your BG every hour while in fasting state (>3h after eating), every 30 minutes for the three hours after eating.
Also, keep in mind that glyburide is forcing you to eat more than you need to. You've got to compensate for the spigot being wide open all the time, rather than just in response to meals. This will make weight management more difficult, and will tend to favor storing sugar as fat (that part of what insulin does).
I appreciate your sharing . that knowledge is so important thank you very much for all your help and information.wish you good health
thank you for your reply and wonderful help, knowledge is so essencial for us. thank you again for all your suggestion. I will read carefully all your advice and keep in my diary.
I have checked my eyes , there is no neuropathy in my eyes no changes yet, thanks God, however I alredy operated cataracte in both eyes, I heard cataracte is also connected with diabetes. I wish you all good health
yes that would be wonderful to achieve 80 in the morning , but is is beyond my possibilites. I have very strict diet,here is my day for exemple:
snack- glass of milk
lunch - pattee (meat) and small piece of vegie- califlower, brocolli, letuce, paprika, or spinach - one of them
snack- cheese, egg, milk,fish
dinner-meat or fish and small piece of vegie
I don't eat flour , nor starch.
I eat only a few vegie= cauliflower broccoli letuce green beans red paprika
I reduce salt to almost zero and my blood presseure got lower, so I had to reduce meds,
I also stopped taking METFORMIN which didn't work for me at all.