I'm "stealing" Janet Ruhl's thunder in a manner of speaking since I ran across this link that is to her diabetes site that she started and maintains but I thought it might be useful to post here. She has some very interesting info re: blood sugar levels and their affects on organ damage including nerves and PN. The post is a little dated but I think still useful as she cites several studies from Utah (Singleton and Smith's work), Johns Hopkins (Glenntaj's neuro, John Griffin) and Mayo Clinic in AZ that all corroborate each other w/ respect to the importance of oral glucose tolerance testing and PN.

She also has links to info re: blood sugar levels and beta-cell destruction (the cells that produce insulin). As one reads the info from the links it becomes more & more evident that even mildly elevated "normal" blood sugar levels, e.g. a prediabetic designation may already be seriously compromising the body's ability to produce insulin and the cells sensitivity to it - an already slippery slope to potentially developing PN.

Even if you are not diabetic or prediabetic the info may be helpful. I did put this up as a sticky too.

http://www.phlaunt.com/diabetes/14045678.php

Alkymst

Thank you. I posted on the other post about this but thought of something cause this is of interest of me. So would the treatment of this be similar to the person with abnormal blood sugar with a similar way of eating? When people get that under control does it reverse the damage or just not further it?Is there pain just when they get there symptoms or no its a daily issues and when consistent in there health the pain lessens?

Wow, that is really interesting.

I LOVE belinda's thread. I'd never heard about this before.

Reading the research was great. Thank you SOOOOO much.

I apologize in advance for the length of this post but there’s a tremendous amount of valuable information and answers on this site as well as links to many others so I collected some relevant links from posts in earlier threads to see if I could help to answer your questions. For someone who is pre-diabetic, like myself, as well as for Type I or II diabetics, dietary control of blood sugar levels to as close as normal is always desirable. Together with exercise and meds, if required, it can go a long way to delaying the onset of complications, reducing the severity of the complications and now the latest clinical evidence proves, unequivocally, that diet and exercise can reverse prediabetes and the painful PN associated with it in some cases.
As for a typical diet the ADA or American Heart Association diets are good places to start and you’ll find many good suggestions from forum members along with recipes too. For myself, I try to eat a lot of fresh fruits, vegetables, whole grain breads, whole wheat pasta, lean cuts of beef in moderation, fish, skinless chicken and turkey, pork and stay away from fatty foods, cookies, cakes, candies, most of the normal “snacks” etc.

Here’s one of the early studies to suggest a link between impaired glucose metabolism (prediabetes) and idiopathic painful PN and the authors were among the first to advocate the importance of an OGTT (oral glucose tolerance test) in the diagnoses.
http://www.jabfm.org/cgi/reprint/17/2/127.pdf

I “lifted” several links from earlier threads to excellent articles about improving and even reversing PN from prediabetes.
http://appneurology.com/showArticle....leId=188500771

http://care.diabetesjournals.org/cgi...ract/29/6/1294

http://www.sciencedirect.com/science...d469fd5964375c

http://www.neurologyreviews.com/may06/neuropathy.html

I think the info below which is a direct quote from Smith and Singleton’s study is the best summary I’ve read to date. Their work showed that there were measurable increases both in small nerve fiber densities and length based on comparison of the 3mm distal (ankle) and proximal (thigh) skin punch biopsies after 1 year in the study. All patients experienced improvement and/or reduction in pain except for those people who had the most severe damage at the outset.

“In the present trial, the investigators performed 3-mm skin biopsies at the distal leg and proximal thigh, at baseline and after one year. Baseline distal IENF density averaged 0.9 fibers/mm, and proximal IENF density averaged 4.8 fibers/mm. After one year, distal IENF density had improved by an average of 0.3 mm, and proximal IENF density had improved by an average of 1.4 mm. The improvements were significant.
“By the study's end, the IENFD (intraepidermal nerve fiber density) had increased by about a third for all patients except those with the worst loss of nerve fibers in their extremities. The improvement in proximal IENFD correlated with decreased neuropathic pain and a change in sural sensory amplitude. "Over the first year of follow-up, IGTN (impaired glucose tolerance neuropathy) subjects lost an average of 4% of their body weight and increased exercise from less than 15 minutes to more than 80 minutes per week," said Singleton.
In a press briefing at the AAN meeting, Smith noted that the findings indicate that the effects of IGTN (impaired glucose tolerance neuropathy) may be reversible. In correspondence with Applied Neurology, Singleton echoed Smith's view, commenting that the findings "are of great clinical significance, because the neurology community regards length-dependent neuropathy in general and diabetic neuropathy in particular as irreversible and progressive. The data underscore the importance of identifying neuropathy patients very early in the course of their disease."

With regard to the pain, I’ve read that the pain may actually worsen initially as damaged nerve fibers regenerate and new fibers are produced but eventually the levels do lessen.
Overall, the studies show that in the patient populations examined that DIET and EXERCISE not only improved glucose control and reduced weight, LDL cholesterol and triglyceride levels but that it improved small fiber function, increased intraepidermal nerve fiber density and improved neuropathic pain severity. I think that there is some reason to be hopeful even if the PN is idiopathic and not directly linked to prediabetes.
Hope this very long post helps a little.

Alkymst

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

I'm gonna save them for my 'morning coffee' reading tomorrow...tho I've peeked at them - It's gonna take a bit more concentration than I have now.

I've always had pre-D or D-1 'ruled out'....but then I had had the 'thyroid' ruled out as well. Well, Duh?

Really, good reading! - j

Thanks for the links. I should send them to my father and aunt, both of whom are diabetic and are under the illusion that they'll be just fine as long as their glucose levels are below 200. I tried talking to my dad about it this summer, but he sees no reason to alter his diet, choosing instead to believe that insulin will make it all better for him.

I was diagnosed with type 2 with a glucose tolerance reading of 188, which is considered "pre-diabetic". But because I have gastroparesis, my glucose levels, once elevated, stay high all day long due to food not traveling through my body properly, so there were times pre-diagnosis that I was probably over 200. Now I am extremely careful to keep my glucose levels under 140 at all times.

I figure that if can manage celiac disease, gastroparesis and type 2 diabetes simultaneously, most type 2 diabetics can achieve healthy glucose levels if they are willing to really work hard at it. I've seen enough of the really dire consequences of diabetes (including amputations) in relatives and former co-workers to be plenty motivated to stay as healthy as possible.

Good to know that I may be sparing myself future neuropathy damage as well.

fanfaire

Thank you so much for that. Its very imformative. I do feel diet plays a role in how you feel but I think I underestimate it to how much it can. Not only body but mind. Sorry for my late thank you response but its so appreciated.

As some of you may know, I am at my 11th day of being sugar free. I have had two minor episodes of pain in those 11 days, whereas my pain before was so excruciating - daily - that I did not think I could go on living like that. At all. Period. No one could even deal with me I was in so much pain, and I have a very high pain tolerance level.

However, to say that I am sugar free does not mean that my sugar levels are perfect or even within normal range yet. I am working on it and will get them there...but am SO amazed at the difference just lowering them has made. I had not had more than one pain free day at a time in the last 9 months.

My sister, who was worse that I was...is now seeing similar (not completely pain free) results.

I so hope ANYONE WHO IS DIABETIC will give this a try if they have not already done so.

I love eating all foods, as well as sugar-laden ones...more than I can say and am in fact a compulsive overeater. But let me tell you....I will fight and give it all up to have the pain reduced!

Fanfaire:

I just had to respond to what you wrote about your father who thinks he is fine if his sugar is below 200. He sounds exactly like my friend E. E has been diabetic for almost 10 years. Her weight is between 280 and 300 (could be more). Every doctor she has seen has told her "you must lose weight". Her response was "what do you know?". When she tells me this, I just tell her about what happened when I went to Cornell and went into their ACCORD program. I lost most of my weight, never looked better, my sugar is completely fine, I get all testing supplies and meds for free. They examine you from head to toe. They send you to their top eye specialist to check for diabetic retinopathy. I said "now why on earth woudn't you take advantage of this? It's free, and you'll get your sugar down". She once said "they'll make me go on the needle". I use Lantus by the way and it literally saved my life. I explained to her "no, they don't make you do anything you are not comfortable with, it's all up to you, they advise you, they support you, they examine you, but if you want to stay on oral meds, they will give you oral meds".

Her response "well, it's too far to drive into New York City". My response "we can take the access-a-ride, we can go to the appointment at the same time (yes, we can do this, I checked). You can go as my guest". It will just cost you $2.00 each way. For door to door service".

So when you give someone all the opportunity to make their life healthier, better and they shrug and say "No, I don't want to go", well, there's a lot more going on here than diabetes, let me tell you. It's the mind, the craving for the food, they don't want to make any changes in their eatings habits.

She has a diabetic stomach. She is ALWAYS sick. Always in the bathroom. She went to the doctor and they told her 'you have a diabetic stomach, you must lose weight and get your sugar down". Her response to the doctor "what the hell do you know"?? When she told me that I said "you know, no one can tell you how to maintain or even improve your health. You obviously don't want to hear anything from anyone, and that most certainly is your right, but let me explain something to you.......and I explained my neuropathy. Well, she said "well, you have neuropathy, I don't" and I said "what the heck do you think a diabetic stomach is??" I explained gastroparesis and she would have none of it. She claims the doctors don't know anything.

So yesterday (after yet another stomach bout), she calls me up and says "I don't understand why my sugar is 213" I said "you have diabetes, what don't you understand?" She said "but I cook healthy (she makes 15 chicken cutlets for her and her husband, he is 65, healthy as a horse, skinny as a chicken and can eat anyone under the table". She blames him for her diabetes. She says "if I didn't have to cook for him, I'd be skinny"

??????????????????????????????????????

I then said "okay, answer me this one, if you cook healthy, you claim you don't over eat, you claim you eat grilled chicken and vegetables, if this is the case, why are you still overweight?"

Her response: "oh, I like to pick at night, I like chips, and pretzels" I said "well, there you go, this stops tonight, and you'll have a head start.

Yeah, like that is going to happen.

Food is a double edge sword with a lot of people. They simply do not get it. She does not get it and she absolutely will not get it. She is now 63, and getting bigger. It's not going to change unless she wants it to and she does not want it to.

You obviously want it to. Your dad, unforunately does not. It's all in how the mind operates the body. If a person gets scared enough about their disease, they will say "oh, boy, I'm not going to let this disease control my life". That's what happened to me and my diabetes.

And with some people, it's the exact opposite. They control their bodies by NOT EATING. Happened to my closest friend. She's been anorexic since she's 14. I am going to her funeral today. She died two days ago. I was with her the day before. I held her. She could not stop the anorexia. She had cancer, but everyone says that if she had listened to the doctor and put good nutrients in her body,well, she might have had a chance.

Want to hear something that will blow you away???

When I was sitting next to my friend on Tuesday, she weighed at the most 60 lbs. It was nearing the end, hospice people were there and they had a little bottle of morphine which they administer via a dropper into her mouth.

She was sleeping. I will never forget what happened.

As the hospice nurse was putting the dropper into her mouth, she woke up and said clear as a bell "what are you putting into my mouth". The nurse said "calm down, it's not food, it's morphine". She quieted down immediately.

I will never forget this. Eating, Or not eating. It's depression, it's control, it's deadly, if it's not taken seriously.

You are one smart cookie. You will get your condition under control.

I do wish you the best. I'm proud of you.

You also educated me. I was under the assumption that if you get your sugar tested and it's 188, you are automatically considered a diabetic. You just taught me that it's pre-diabetic.

See, learn something new every day!!

be well,
melody