Hi everyone. Wish I could say I was happy to make your acquaintance

I have type 2 diabetes and my glycemic control was non-existant for many years. I'd frequently have A1C levels of 11. On top of that, my alcohol consumption was quite high. I knew this was a recipe for disaster, but took no action.

About a year ago, as I turned 40, I started having constant PN symptoms in my feet. This time, I sprung to action. I lost 90 lbs and managed to stop drinking completely. Currently my A1C levels are great -- 5.6. I still have some dawn effect (levels of around 110 mg/dl in the morning and a spike after breakfast).

Sadly, despite taking action my PN still seems to be progressing. This can happen when rapid glycemic control is achieved, I guess. Or maybe my abnormal fasting levels (despite good A1C) is still causing damage. Or perhaps its just the cold weather.

The worst symptom for me so far is just the damn anxiety of not knowing if I've managed to stop the progression, if it might ever improve a little, how the gapabentin is affecting my brain, etc. Some days the anxiety just basically takes over my life.

The next worst symptom is the constant cold feet! Sometimes they feel cold when they aren't, but most of the time they are actually cold. And the "actually" cold phase usually happens just before a flare-up of extra tingling/numbness/hypersensitivety.

Question: I know for diabetic PN the vascular system is usually damaged as well. But it seems like this symptom is common for many types/causes of PN. Is there a mechanism behind this other than vascular damage? Is it a feedback loop, with the damaged nerve signals causing vasomotor disfunction and blood flow to restrict?

I get a wonderful respite each morning until about noon, and then within an hour the cold sets in and then wavers a bit for the rest of the day. I just wonder what it is my body is "running out of" that causes this transition.

Wow, that was very long winded. Thanks for reading.