I finally found a link I'd been looking for, and wanted to post it here for anyone who is going to go down the path of checking for blood sugar issues.

For those who don't know me, I pass all normal diabetic screening tests with flying colors, but below is what further investigation on my part showed.

After a very high carb meal of pasta and bread, this is what my blood sugar did:

Pre-meal: 85
30 minutes post-meal: 166
1 hour post-meal: 162 (under 140 deemed normal)
2 hours post-meal: 166 (under 120 deemed normal)
3 hours post-meal: 148
4 hours post-meal: 128
6 hours post-meal: 82

It took me over 4 hours to return to what would be considered normal post meal blood sugar levels when I should have been there in two hours.

This link tells you how to test with a glucose meter and interpret the results:

http://www.phlaunt.com/diabetes/14046889.php


This link shows what normal blood sugar levels should be. I've read as high as 188.

http://www.phlaunt.com/diabetes/16422495.php


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Hi there,

My small fiber neuropathy is not related to diabetes, so I have been advised by my professor in London...but...I had diabetes in both pregnancies so have a bit of knowledge re this

I am quite small and thin and do not have any weight issues but when I had my first son it was picked up on a scan that I had too much fluid, I was then given a glucose tolerance test which showed slightly raised glucose, I think it was 8.1 after 2 hours. Should be under 7.8. I ended up having a C-section as it was quite risky with all the fluid.

With my second son they monitored me very closely , I had to test before and after meals, my bloods were running high after meals, but strangely I had an normal glucose tolerance test. The consultants said even though I had a normal test it doesn't mean I don't have it! so this proves that the test isn't that accurate to pick up pre-diabetes, the only way to know for sure is if you test after meals with a kit, to see how your body reacts to different foods. Just by having slightly raised blood sugars caused big problems for me in my first pregnancy, so I am guessing that if left unmanaged could cause other problems too i.e. small fiber neuropathy.!

I think that's exactly what I've learned.

If any good has come of this neuropathy crap, it's that I've hopefully warded off an eventual pre-diabetes or diabetes diagnosis. But I'm also still kicking myself for not getting a better understanding of what developing reactive hypoglycemia meant.

I always thought glucose intolerance was pre-diabetes, but it wasnt, it was "pre-pre-diabetes", it precedes diabetes or pre-diabetes by many years. im starting to think GI is related to my pn, because it fits in the symptom(type and presensation) alot.

Harvard's Joslin Diabetes Center says 20 million people in the U.S. have Impaired Glucose Tolerance, and 1% - 10% of them will be diagnosed with diabetes every year. I'm sure a good hunk of them don't know they have it, as was the case with me.

http://www.joslin.org/info/diagnosin...rance_IGT.html

I posted a link to this report before on another thread, but I think it's worth posting again because of what it says about neuropathy. The case studies referenced ring very familiar and are worth a read, but I'll copy and paste the most relevant and summarizing areas of the report.

Peripheral Neuropathy and “Borderline” Diabetes

http://www.jabfm.org/content/17/2/127.full

"There is increasing evidence that patients with milder degrees of abnormal glucose metabolism, including impaired glucose tolerance (IGT) and impaired fasting glucose (formerly referred to as “borderline” diabetes), are also at risk for developing symptomatic polyneuropathy . We have personally observed patients for several years with “idiopathic” painful sensory neuropathy who subsequently develop overt diabetes; in retrospect, it seems likely that their symptoms were related to longstanding impaired glucose metabolism."

"DISCUSSION:

The cause of polyneuropathy remains unknown in more than 20% of cases despite extensive laboratory testing. The incidence of idiopathic cases is believed to be even higher among patients presenting with painful sensory neuropathy. However, some patients with “idiopathic” painful sensory neuropathy have ultimately developed overt diabetes mellitus after many years of follow-up, suggesting that occult impairment of glucose metabolism may have been the cause of their symptoms all along. There have been a number of recent series suggesting than more than 50% of the patients referred to neuromuscular clinics with a diagnosis of “idiopathic” painful sensory neuropathy have abnormal glucose metabolism when they are evaluated using the 2-hour glucose tolerance test (Table 3). Of these, more than 50% have impaired glucose tolerance, so the fasting glucose and glycohemoglobin are frequently normal despite an abnormal glucose tolerance test. These incidences of occult diabetes and impaired glucose tolerance are significantly higher than those reported for the general population, suggesting a causal relationship.

"CONCLUSION

Based on the data available in the current medical literature, we suggest that patients presenting with unexplained painful sensory neuropathy should be evaluated for impaired glucose metabolism with a 2-hour OGTT; if the results of the test are abnormal, they should be referred for lifestyle interventions and/or initiation of oral hypoglycemic agents in addition to management of neuropathy symptoms. Improved glycemic control can prevent the
development of overt diabetes mellitus and may have some impact on progression of neuropathy in these cases. The association between “idiopathic” painful sensory neuropathy and impaired glucose metabolism argues very strongly for prospective studies in larger populations looking at the cost effectiveness of this approach."


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I think i might have read that article, it said people with GI, might be the cause of idiopathic PN . Since diabetes, is the major cause of PN, it wouldnt hurt if there was more on pre-diabetes and glucose intolerance as well.

I have been trying to get better at all things diabetic and I started this coaching program where nurses call and make appointments for phone schooling. My last conversation included instructions to test 2 hrs after meals and anything 180 or lower was cool. In my old process I tested fasting in the morning and 80-120 was good. I sure hated giving up those tortillas at McDonalds, but even more things are going to have to change. I'm not trying to open up a can of worms, I will peruse the link and check it out. Good Luck, Ken in Texas. P.S. Diabetes-horseshoes-handgrenades, as long as we are close.

That 180 number is consistent with what I've seen for diagnosed diabetics. I assume you are one? I think it's the ADA guideline. Other organizations like the American Association for Clinical Endocrinologists say the 2 hour number should be below 140 for good diabetes management.

The numbers in those links I posted are for determining if you have a glucose problem at all.

I'm sure there's a good deal of genetics involved with the susceptibility to neuropathy from all the various insults. Given no other theories, I'm going to consider myself to be a poor schmuck with bad sodium channel genes who has been done in by even mildly elevated blood sugar. If that's the case, I feel it's in my best interest to be an "overachiever" with regard to glucose management.

Hi Janieg
I just noticed you take 100mg R lipoic acid twice daily. Is that considered a safe dose? Is it too high? I am currently taking 100 mg daily and thought of upping it but literature I read is contrary. Thank you

Hi Aussie,

When I first started looking into it, I read somewhere that you can take 600 mg of ALA twice daily to help with neuropathy as long as you have no side effects, including your blood sugar going too low. I can't lay hands on the exact article I read now, but I do remember reading that. I started with 100 mg of R-LA, and when I felt no side effects, I bumped it up. I do believe it has helped me, but am soon going back down to 100 mg to see if I feel any difference. It is rather expensive.

I should also add that I tested low-normal for ALA in a NutrEval test, so that also factored into my decision.

I just did a little Googling and found this write-up on it. This wasn't what I read initially, but what I read was probably a summary of it as I remember it had references to a German study.

http://www.diabetesaction.org/site/P...lementary_5_12

"A small Romanian study of 26 patients found symptomatic improvement with oral ALA (600mg daily) after three months. Ziegler replicated these findings in the 2006 SYDNEY-2 trial, finding that oral doses of 600, 1200, or 1800mg of ALA for five weeks led to significant improvement in neuropathy symptoms, with the best safety profile at 600mg. Notably, side effects were observed and included nausea, vomiting, and vertigo, which increased in a dose-dependent manner between 1200 and 1800mg per day."

Cheers!

Janie