I'm trying to make sense of my glucose tolerance test:

Hemoglobin A1C : 6.0 H
Time 1:131 mg/dl
Time 2: 107 mg/dl
Time 3: 83 mg/dl

All I know is that they said I was OK. I'm not sure what the Time x values should be, but what I really wonder about is the Hemoglobin A1C--the reference range says <6.0%, so doesn't that mean it's high?

I just keep coming back to Occam's Razor: diabetes is the most common cause of PN (isn't it?), diabetes runs in my family, I'm 54, and about 30 lbs overweight. Seems to me that diabetes is the simplest, therefore the most likely explanation.

While I don't understand this test, I recall that my glucose is usually right on the edge of the edge, i.e. not in the range they call prediabetes but only under by one or two points. One time, it was solidly in the range.

Do you suppose that I am close enough that prediabetes could be the culprit, and what would you do if you were me?

A1C of six is borderline diabetic. I have 6.2..stable for a year.

This link has a chart:
http://www.medicinenet.com/hemoglobi...st/article.htm

An A1C in an older person tends to be higher than in a younger.

Yours, I would follow a high protein diet, with limited, low glycemic carbs... to keep it at what it is, so it does not go up.

You can request a fasting INSULIN level... If this is elevated, consider yourself Type II almost or there. One diet very good for controlling this is the Zone diet. It is pretty easy to follow.

Hi,

I have the same problem. I have small fiber neuropathy in my feet and lower legs. I'm 27 years old male and I'm not overweight (6' and 155 lb).
My grandfather had diabetes type 2.
My neurologist ran dozens of tests on me and the only test that was abnormal was A1C. It's 6.0. My B12 level is 512.
My neurologist is not sure whether my A1C level causes my SFN, but recommended me to try to lower it under 5.5 and see if it would help.
Currently, I'm trying to limit my carbs intake to 100 grams per day (approximately 30 grams per meal). These 100 grams of carbs come mostly from fruits and vegetables. I exuded pasta, sugar all grains and bread from my diet.

I'm also taking:
1) R-lipoic Acid 100 mg/day
2) Acetyl-l-Carnitine 1000 mg/day
3) Multivitamin Now Adam. It has a good amount of B group vitamins. Including B12 as methylcobalamin.

I just started my regimen (1 week ago) and have not achieved any positive results yet.

Most fruits and their juices are very high in the carb count!

Everyone has good points (but I think ibkr was saying he counts whatever fruits & veggies he eats toward his carb total rather than eating whoopie pies, which is good!)

Anyway, the essential question I was trying to get answered is if even such a slight indication of prediabetes could cause PN. Of course I need to heed these warnings whether or not it's causing it--I do understand that this is serious business all around. But it would be nice to know my enemy where the PN is concerned. And also nice to know that I can work to head it off before there's even more nerve damage.

Does anyone know how they determine diabetes as the cause? Or do they just assume if you have diabetes, that must be the reason?

--that if one has frank diabetes and neuropathy, doctors tend to assume that the former caused the latter. That should not be assumed, though--it's lazy doctoring. Not all diabetics get neruopathy (though many do); it's certainly possible to have neuropathy from some other cause.

On the other hand, many doctors still don't know that glucose dysregulation short of frank diabetes--impaired glucose tolerance--can also result in neuropathy. Too many doctors still think that one has tohave diabetes for a while to develop neuropathy. (I have several threads on Neurotalk in which I've compiled lists of studies that demonstrate this--you can easily seach for them with my name and the term "impaired glucose tolerance").

The general mechanism for neuropathic damage due to glucose dysregulation involves excess nitric oxide production and oxidative damage tot he nerve fibers. There are a lot of articles that detail this--one of the best researchers in this area is Dr. Aaron Vinik, who has written extensively about the process of nerve damage (I have a paper of his describing autonomic neuropathy in diabetics in the Stickies).

I also think the LOW blood sugars that occur in diabetics and those with insulin resistance are problematic too.

It has been noted recently that one episode of very low blood sugar in diabetics (which can be very common) is enough to accelerate Alzheimer's risk.

http://www.dailymail.co.uk/health/ar...ing-brain.html
This study above illustrates the glucose problem. Good blood flow with low sugar in it, would be a factor too.

Here is another about hypoglycemia:
http://www.medicalnewstoday.com/articles/146021.php

I imagine all nerves suffer when glucose gets too low.

When blood sugar is high, that means the cells are not getting any either, since the mechanism of transport seems to be not working (or insulin is missing).
Also the damage to peripheral nerves can be due to sorbitol being formed in the periphery.
http://en.wikipedia.org/wiki/Diabetic_neuropathy

I think we see in the ACCORD program, where the aggressive arm was closed early because of DEATHS, that keeping glucose TOO LOW or trying to keep the HbA1C around 6 (and under 7) led to death in that study. The total results have not been published yet, and when they are, it should be very revealing. The ACCORD study was about diabetics and glucose control. The other patients were allowed HbA1C of 7 after the more aggressive arm (group) was closed.

Keeping elderly patients at levels that are considered "normal" for non-elderly patients, may be a huge mistake, and lead to all sorts of pathology and loss of quality of life, and perhaps even death to some!