Great post Alkymst, being once Prediabetic myself with small fibre damage & some large involvement as well, all of this makes very good sense.
My neuro was confident even 4 years back that if i done the right thing i would be able to fully reverse my PN in time, which has happened to about 98 % of the damage, still got a little healing to do.
I think anyone that fits into this area should take diet, exercise and supplements very seriously and worsening of symptoms is normal as the nerve's regenerate which goes on periodically right through until the nerve's are healed, the same deal with Diabete's 2.
Brian