Sudden onset neuropathy

Hello. I’ve been a type II diabetic for about 12 years first controlled by diet and exercise. Started Metforim 500 Mg about 9 years ago. My doctor was never really concerned about my glucose levels since my A1C was always under 6.5. In recent months it’s been in the 6.1 range. I am thin, exercise and eat very healthy (low carb). However, I started experiencing severe neuropathy over my entire body about a year ago, including red burning feet. My doctor said he did not think it was from diabetes. I went to 4 different doctors … 2 neurologists, rheumatologist, cardiologist and lastly a holistic doctor. Still no definitive diagnosis, I finally made an appointment with Cleveland Clinic myself and just returned. Diagnosis? Small fiber neuropathy and autonomic neuropathy caused by diabetes! From what I understand and from the research I have done, glucose intolerance and pre-diabetes can cause just as much nerve damage as with a full-blown case. Cleveland Clinic recommend I see a endocrinologist. Also told me to take 600 mg. of Alpha Lipoic Acid since it has been proven to help nerves regenerate when taken at least a year. Just wondering if anyone else has had neuropathy come on suddenly? Not sure if the endocrinologist will recommend any thing different for me.

Hi @BeBe2, I have moved your post to the main forum so it will be seen by a larger audience.

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A1c of 6.1 is an average blood sugar of around 135. You might be one of the unlucky people who is very sensitive to even slightly high sugars.

Alpha-Lipoic acid may help, but if you can’t stop whatever is causing this (high blood sugars), then likely it will be progressive, which is not a nice prospect at all.

Have you ever worn a CGM? How high are your highs? Even if they come down there is some school of thought that highs do cause damage, and that very tight control (keeping sugars in the 70 to 120 range all the time may be helpful).

Your best bet might be taking all efforts to reduce blood sugar to truly normal levels which are hba1c in the 4.2 - 4.8 range (if one follows Bernstein), but definitely in the low 5s. And Blood sugars as stable as possible and as close to 83 as they can be maintained! Sounds like you are already doing the diet and exercise thing, so the next step is medications - other than metformin. Best bet would probably be insulin.

Have you been properly tested for type of diabetes? Could you be type 1 (adult onset)? If you are tested and found to be insulin deficient, low dose insulin may help you get much tighter control.

Suggest you research and decide what you want from this endocrinologist and then request it.

Some here think Dr. Richard Berstein is too strict (Book - Diabetes Solutions, u-Tube "Bernstein Diabetes University), however, I think his teachings are your best bet at getting non-diabetic sugar levels and having a chance of reversing this.

No I haven’t worn a monitor before. I think my problem is fasting and postprandial glucose (particularly 2 hours after my daytime meal). I’ve have had my A1C checked every 6 months for the last 10 years. I also recently had a blood test called Anti-GAD which indicates whether or not you have Type 1 diabetes and predicts if you will ever need to go on insulin, but mine came back normal (thank goodness). I started taking 1,000 mg of Metforim two weeks ago and was tested yesterday. My A1C dropped significantly to 5.7 and 97 glucose level non fasting. Just perplexed with all the body wide neuropathy.

I give that book 300% rating as I bought three editions of it from 2000 onward before I joined this tudiabetes group in 2009 and I did pay attention to the DrBernstein section here. I think he is great.

I also fully recommend the videos by Dr Jason Fung for all diabetics. He is a nephrologist based in Toronto who has many diabetic patients on dialysis. So that is why he is so upset with standard ways of mistreating diabetes with lackluster approaches that are not well thought out. So it is possible to find great doctors, so having youtube is a great way to listen to what they have to say. So, yeah, I love Youtube as a resource.

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Take a look at this article in podiatry and realize that metformin is noted as a culprit.

Lots of people who undergo chemotherapy also get neuropathy and so do people who take drugs for HIV and for fungal infections as they end up inhibiting the proper assimilation of vitamins like B6.

Also the fact that antibiotics kill off bacteria means that any sensible doctor should advise the use of probiotics right after and get the friendly bacteria back to normal to keep the patient healthy but I BET most forget.

https://www.podiatrytoday.com/blogged/metformin-use-increase-the-risk-of-diabetic-neuropathy#:~:text=Wile%20and%20colleagues%20noted%20that,as%20reduced%20levels%20of%20B12.