--even a lot of endocrinologists, order a two hour test with draws before you drink the glucose solution, and then at 1-hour and 2-hours, because that's all they've been taught (or all the lab/insurance will let them do). But this schedule is probably not the best for noticing subtle signs of glucose impairment.

One's glucose level SHOULD go up somewhat from fasting level upon drinking the glucose solution. The keys are how much it goes up and hwo quickly it goes back to "normal" levels, if it does. Most test reports have scales that indicate, at each time period, what indicates "impaired glucose tolerance" and "diabetic", and you're generally allowed a much higher level at 1-hour, labelled as "normal glucose metabolism", than you would be at two hours.

Obviously, if one shoots up to extremely high levels at 1-hour, and stays relatvely high at 2, one has problems. Usually this indicates that one has insufficient insulin to regulate serum glucose. But subtle signs of impending trouble may well be missed by these. One can have "normal" glucose readings and still have metabolic syndrome or insulin resistance--and generally, the scrips aren't written to monitor insulin levels as well as glucose, which can often be revealing, especially if ones starts before the drink with an elevated level of insulin, indicating the body is insulin resitant and needs to produce more to keep glucose in check.

I've written about this a lot, but a several hour test, with more frequent blood draws, and measurement of both insulin and glucose, can often be more revealing--the pattern of the two moving in tandem is often revealing, too. I have mine done for four hours minimum, with glucose/insulin draws at baseilne fasting and then every half-hour. (I admit this makes you a pincushion--and is boring besides, as you can't be physically active during it, which skews the results.) In my case, I start with normal glucose but elevated insulin, have some glucose rise but a bigger insulin spike, which drives my blood sugar leels to lower than fasting in the second-third hour (reactive hypoglycemia); the insulin then recedes and my glucose inches back up to normal. This indicates my body is resistant to insulin effects, it takes more than it should to keep my glucose in check. I'm not diabetic, but I have to watch very carefully, and so I exercise as much as I can, and try to eat in a Zone like manner to keep my glucose levels more stable (and I take R-lipoic for its glucose regulating effects).

I went to enocronologist today.
My fasting number is 88.
1 hr 156
2 hr 154

The doctor this is mild and docent answer to why you are having so many problems. She said your non fasting and fasting have been normal or borderline so people who get diabetic neuropathy are the ones that have had it uncontrolled at high levels for a long Lo g time.

But my neuro told me if I am glucose I tolerant that might be a cause!! So this is just crazy
She said I can try meltformin but doubt it will do anything for my symptoms.

She said it is a clue to watch my diet for the future.
Plus I ha her run some anyibodies to thyroid and repeat tsh panel.
Asked her about thyroid, paratheoid disorders and link with gtt and vitamin d deficiancy but she didn't seem to e bothered by anything.

If I am glucose intolerant should I check my pancreas?

Oh and she told me to do vitamin d3 drops. I have the nome written down but it's OTC.

Plus it turns out she has same symptoms as me and
Has seen same neuro as me and is in the same boat with no answers.
It was funny as we discusse same symptoms!! She was like man I thought I was the only one. I told her to go online and see how many of us are sufferig!

Tulips

Hi, you do not have to have high uncontrolled glucose to get nerve damage, prediabetes is a pretty well known cause of nerve damage these days, I was only at prediabetic levels when I had all my nerve problems.

--although a lot of doctors are still behind in their continuing medical education on this, impaired glucose tolerance not yet to the point of a diganosis of frank diabetes is becoming more recognized as a generator of neuropathy. (And that 2-hour level does seem high--it's possible to have "normal" fasting glucose levels but an abnormal response to glucose challenge, indicated impaired tolerance.)

I've written about this a number of times in the past, with links to papers one can read and take to the doctors who still seem to believe one has to have diabetes for years before getting neuropathy:


http://intl.neurology.org/cgi/content/abstract/60/1/108

http://www3.interscience.wiley.com/c...TRY=1&SRETRY=0

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16448668

http://www3.interscience.wiley.com/c...07929/ABSTRACT

http://www.ncbi.nlm.nih.gov/entrez/q...d_AbstractPlus

There are many others--it's sad that so many doctors aren't aware of this.

I think starting a good diet is important now.

The one I like to recommend, has validity for controlling blood glucose levels and inflammation..

The Zone.

It is easy to follow, and very helpful. In essence, it avoids high glycemic carbs and sugars, moderates saturated fats, encourages essential fats, and balances carbs with protein.

http://www.zonediet.com/Default.aspx...ooglePPCsearch

Your library may have his books. Controlling inflammation is important for PNers IMO. Inflammation results from insulin spikes that occur during impaired glucose metabolism and from eating sweets. Insulin can be a stimulus to creating inflammatory cytokines which are implicated in nerve pain and damage.

This explains further:
http://www.womentowomen.com/inflammation/causes.aspx

In essence.. eat more omega-3, less omega-6, and remove sweets and high glycemic carbs.

Can the non-length variety (sensations all over body) be caused by Glucose Intolerance problems/prediabetic?

According to my endo ronologist "no"

She said it's only innpeople with very high and uncontrolled diabetes for yeRs! But I don't think thats accurate.
Any ways she ran some more blood work and some antibodies so let's see

--that's not accurate at all--see my other post (with lots of references) on the possibility of neuropathy from impaired glucose tolerance that is not yet frank diabetes. (You might want to print out, of send the doc links to, a few of those--we do often have to educate the physicians.)

And, while the classic presentation of impaired glucose/diabetic neuropathy is, as Dr. Vinik says, of small-fiber length-dependent disruption, large fibers can be affected also:

http://neuromuscular.wustl.edu/nother/diabetes.htm

Most doctors are very poor in chemistry. They typically only have basic skills in it.

The chemistry of insulin creates inflammation when insulin levels are high. Dr. Sears explains that, as he is a biochemist. Insulin levels can be very high, and your testing for blood glucose normal or close to normal, and it is the INSULIN creating the problem, NOT the glucose directly. The glucose is acting only as a trigger. Before diabetes occurs, this process is ongoing...it may be a short time frame and then you get failure of insulin secretion from the pancreas, and then you have high sugars. But some people can live at this state of insulin resistance for a long time (genetically predisposed) and while at this level of high insulin which is abnormal, inflammation and damage is occurring to your body..nerves, blood vessels, etc.

You should get the books by Dr. Barry Sears and read them.
His first is Enter the Zone, and has two chapters on this chemistry. Change your eating habits now, and you may feel much better in the long run. You don't need a doctor to do this or drugs.

This diet The Zone is not radical...like Atkins or some others. It is easy to do and gives results. You can use it to lose weight, and/or decrease inflammation.

Hi Glenntaj,
I understand that an 8-hour fasting is required for the Glucose Intolerance Test. The laboratory opens at 7AM (most likely I will be attended immediately since I come in very early). I take my Synthroid at 4AM, VitB12 at 5AM and Gabapentin at 6AM. Can I take these medicines prior to the test?

My doctor did not give me any instructions neither is returning my call. I am going to take the test by Friday/March 16.

Thank you for your reply.