I have suffered from moderate to severe nerve pain for four years now. I am on 3000 mg of gabapentin.

After having several high blood glucose tests, Dr had me take A1C. This test showed 6.2.

Is it possible that this could be a factor in nerve pain?

Nerve damage can begin to occur any time after your blood glucose goes above 150. Doctors do not tell you that but do some research and you will find that out.

So yes. I don't even have diabetes, nor technically, prediabetes, though I say I AM prediabetic. I have a meter and try to keep my numer below 150.

--that there is considerable evidence that neurological symptoms can present well before frank diabetes is diagnosed, while one is in the category of "impaired glucose tolerance" (and that many doctors are unaware of this evidence and think diabetic neuropathy only happens after many years of severe blood sugar dysregulation).

Don't have a lot of time this morning, but searching my name and posts here will bring up links to a LOT of papers and studies about this. It's certainly worth investigating.

I was in your position four years ago. I found my neurologist at Mass General. She is one of the leading pain researchers in the field and pointed to my pre-diabetic status as a possible cause of my nerve pain. As a result, I ended up having Gastric Bypass surgery to take care of my weight issues, which resolved many co-morbid conditions including glucose intolerance, sleep apnea, high cholesterol and high blood pressure. I lost 125 pounds doing this and got into the best shape of my life, despite the nerve pain. It was hoped that my SFN would resolve itself. In many cases it can.

Unfortunately, it seems that my SFN may instead be autoimmune related. I am waiting for more answers from my doctors. Taking care of your blood sugar is definitely an important piece of the puzzle. Good luck.

My Ruemi said the same thing, even after telling her that my father had PN too, she said "He probably had diabetes and didn't know it", really? My Neurologist I went to 10 years ago Dx'd it as hereditary neuropathy, somehow that makes more sense, since I try to keep my bloodsugar under 110. I have also had PN for almost 30 years, but I could have had high bloodsugar back thenm as I was a sugerhulic back then. I think at the end of the day, if there is no obvious cause, it doesn't much matter what caused it, as they don't seem to have a clue how to cure it... Maybe if I exersises more... ;0)

Since you mention that you were diagnosed ten years ago with a hereditary neuropathy perhaps you should pursue having DNA blood testing to hopefully find out what you have. Sounds like your father also had it. If you do not mind sharing, what other symptoms do you and your father have?

DNA blood testing is expensive. Perhaps insurance would cover the cost. If it turned out to be something such as CMT there is no cure/treatment at this time. There are over 70 types identified so far.

If CMT were the case it can be exacerbated by going too far with exercise. No pain, no gain is not for a CMTer.

I could not get past 2700mg of gaba when my neuro had to lower it to 1800mg. At the 2700mg I was just pretty much out of my head. Even the 1800mg bothers me a little but I deal with it.....my neuro recently added Cymbalta and I'm up to 90mg a day. Can't tell any diff since he added the Cymbalta except I think I'm more 'aware' of what is going on around me.

My A1C went up to 8.7 due to chemo but I still didn't think that was very high but between the 8.7 and chemo drugs it destroyed the A and C fibers in my feet. Confirmed via skin punch biopsy.

I've read that the skin punch biopsy might become a regular test in the future for pre-diabetics as a way to monitor any damage to the nerves so hopefully treatment can reverse any damage.

Debi from Georgia

The Neurolagist wanted to do a DNA test, I was and still are a cash patient, they wanted $3,000 for the test, but he also said there was no known cure, so I thought it would be throwing money away. I had already had symptoms for 16 years, so I knew I had some sort of PN. It makes more sense today to get the test, as more is known about the different types of PN, so it might be worthwhile. Probably is cheaper for the test now, too.
My father had the burning pain in his feet, he told me, at one point it felt like a fuse burning up his legs, he lost feeling in both legs. I guess this would be considered large fiber involvement. I am getting a progression of pain up my legs to the knee, but not numbness. He also had widespread muscle pain, similar to FMS or maybe MFS. The tendons were like ropes and the muscles were always constricted. He used to solicite back rubs from us kids, as far back as I remember. I have the same muscle tension in almost every muscle. I was thinking FMS, but I have not had many headaches, and my GI track is fine, it is mostly just e tight ropey tendons and muscles with big knots, that do not untie. In fact I had surgery on both my shoulders to surgically remove the tendon knots on my bicep tendons. They were rubbing on the bone and dislocating my tendons when I lifted my arms. Then the last procedure was infected with staph during surgery, so I had to have two more surgeries and gallons of antibiotic IV's, but that is mother story...
That is why I was surprised my Rhumitologist dismissed the family history with "I don't know your father" I guess meaning I made it all up. She says it is just muscle pain caused by wear and tear, even though it has been like this since I was a teenager, many many years ago...
I am wondering if the muscle involvement was caused by small fiber neuropathy?
Sorry for the long winded answer.

Poor you!
That Gabapentin is like stuffing your scull with cotton! I used to have bad brain fog, before getting on a low carb diet, I have been pretty good for 7 years, then start taking GABA, it was like starting over, couldn't remember names, or even finish sentences. I am glad that was short lived, and I was taken off it. I don't think they will try Cybralta, as this interferes with hypothyroid treatment. So the next level is opioids, and I know 10/325 Vicodin does not even touch the burning pain in the feet. Also, they all give you the evil eye, when you go to the pharmacy, like you are just another drug addict. But I am at that point in the pain threshold level to try anything that helps!
Good luck!

I'm a Vet and the VA gave me Gabapentin, and had to take 3-6 daily. Found out this stuff can "fry your liver" too. This medication is mainly used by epileptics. Please be careful. Its your decision.