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Discussion Starter · #1 ·
Hello!

I posted a question about my neuropathy in the "Complications" folder, but perhaps I should have asked it here. So here's an edited version!

I'm 29 years old and was in excellent health until recently. I have a strong family history of both diabetes and thyroid disease. I'm thin, eat relatively well (though could improve certainly), don't smoke, not taking any meds other than a multivitamin and Omega 3's. My dad has had type 2 diabetes since his 40's as well as high BP and heart disease despite good BG control and a carefully planned vegan diet.

For the last 4 months I've been having crazy symptoms. One of the more significant symptoms is polyneuropathy in my feet. It came on suddenly one day along with dizziness, nausea, shakiness, blurry vision, and confusion. It resolved after 2-3 hours only to happen again the next day (and on and off every day since then), though not all symptoms at the same time.

I've seen a neurologist and he said that I can't feel vibration (with a tuning fork) or sense temperature appropriately in my feet. Sometimes they feel pretty normal and other times they get ice-cold, turn purple or blue in patches, tingle, go numb, very sore big toe, etc. I also have significant burning in my legs at night (mostly the calves). I do get mild tingling in my hands from time to time, but not nearly as bad as the feet. I also get muscle pain, tingling in a patch on my back and my left cheekbone, vertigo, tremors, and trouble thinking clearly quite frequently. When I don't eat regularly I get ravenous, irritable, shaky, and confused BUT this isn't new - that's happened for several years and resolves fast when I eat.

I had my HgA1c and fasting BG measured. They were 6.0% and 5.9 mmol/L respectively (2 months ago). I live in Canada so I think the BG readings might be in different units than in the US. The neurologist said these were both a bit high, nothing really serious, but worth pursuing with my PCP. I went to her and she said they were totally normal - she didn't even want to do any further testing. She said anything under 7 is fine for the HgA1c. I thought that non-diabetics should be much lower like 4's and 5's. Thoughts?

I also have mildly low iron (I'm taking supplements) and have a positive (fairly high) ANA test indicating possible autoimmune disorder though all antibodies tested for were negative. I also had elevated chromium?! B12 is normal. Thyroid is normal. I've had a normal MRI so there aren't any obvious compressed nerves and I don't have MS or neurological disease.

So... do you think that with an A1c of 6.0 I could experience nerve damage? Or is it unrelated to blood sugar? Are my results normal and fine as my PCP says or borderline as the neuro says?

I'd love to hear your comments!

Many thanks,

Zoe
 

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Hi Zoe,

I dont know much about the neuropathy, but I can tell you that you need to get a seconed opinion from another PCP or Endo on the blood sugar levels, I saw a Dr for 11 years until last year.. he had steadily watched my A1C climb from the mid 4's to almost 6. My Co workers, one who's husband was diabetic insisted I change Drs or atleast get another opnion when my blood sugar would get to 200 and fasting was 156 and my Dr's office said ' dont worry '. I did get another opinion and now have changed completly. My new Dr told me she never takes chances with borderline numbers because the early you catch it the more you can do with it. Early on you have more choices. My Dr also told me 6.0 in her opinion is early diabetes and no blood sugar in a normal person should reach 200.
Get another opinion from someone with a fresh perspective and ask for a glucose tolerance test. Good luck:smile:
 

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Discussion Starter · #3 ·
Thanks Tami!

Just figured the US/Canada conversion too... my fasting BG was 106 when tested a couple months ago.
 

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I'm new to all this Zoe, but I just got my Ac1 levels back at 5.7, they said that is "pre-diabetic" and over 6.4 was full on diabetes... I'm taking all the precautions I can now to avoid it going up. I too have a family history, my dad, granddad, 2 aunts all have type II and my dad has had 4 heart surgeries, so I'm not taking it lightly. I am also going to the gym and doing low carb from here on out and will retest in 6 months!

Good luck, I personally haven't had any symptoms, so keep getting more opinions!
 

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Different countries use different HbA1c cut offs. I think Canada may use 6.5 whereas the US uses 6.0. Some doctors will dx pre diabetes in the high 5's based on a fasting over 100. In the few years prior to my dx I was experiencing a lot of pins and needles in my feet, cramps and pains in my thighs. Since I was not overweight and no family history of diabetes and I exercised a ton, diabetes was the farthest thing from my mind. Stupid me thought it had to do with too much exercise. Now I know it was probably the early stages of neuropathy. Once I got a meter and using it to keep bgs around 100 or under a lot of it seemed to heal itself. I know a lot of pre D's who start to get neuropathy. So what that means to me is damage can start to occur at lower bgs than what we are asked to keep ours at. The ADA suggest HbA1c of 7% which is an average bg of 154. I feel it is my body and will not risk the damage caused at that level.
 

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Hi Zoe,

An A1c of 6.0% is simply NOT a safe place to be, and is certainly indicative of possible future problems.

Fasting BG is often one of the LAST Places to show real problems, and isn't a good indicator.

The best indicators are the A1c (yours is above normal, there's Dx'd diabetics keeping their A1c in the 5% range) and the OGGT (Oral Glucose Tolerance Test).

FYI Normal A1c's are approximately 4.6% to 5.4%. Also, if by chance you're anemic, your A1c result will appear MUCH LOWER than it actually is...

With a family history of Type II diabetes, a high A1c result and some other diabetes symptoms, I'd ask your PCP for a referral to an Endocrinologist. I'd also start on a low-carb lifestyle and daily exercise, and keep with it...
 
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Neuropathy

There are many different causes of neuropathy. Diabetes is only one. Diabetic peripheral neuropathy tends to be a complication that presents after years of hyperglycemia, and is probably related to disease of the small vessels that feed the nerves. For neuropathy to be occurring at your age with a HgA1c of 6.0 is an indication that the neuropathy is NOT caused by diabetes in your situation.

Another common cause of neuropathy is rheumatological and autoimmune illness. Auto-immune disease would also (easily) explain most of your other symptoms, including the vertigo and the Raynoud's phenomenon (distal extremities turning white, red or blue). Ironically, we are starting to understand that diabetes ... and insulin-resistance in particular ... is an auto-immune processs. So is much of thyroid disease. The fact that you have a strong family history of both diabetes and thyroid disease, and that you have a positive ANA is quite typical for autoimmune illnesses... which often take years to diagnose. It is not at all uncommon for people to be antibody negative ... confusing the diagnosis. Truth be told, we probably only have a subset of antibodies that we know to test for (like rheumatoid factor). The other thing that is quite common for autoimmune illness is that it can literally impact EVERY organ system in a waxing/waning way: Skin, muscles, connective tissue, lungs, kidneys, GI system, joints, mental health/cognitive functioning, vision, anything. I would highly recommend a rheumatology consult.
Best wishes. Hope this was helpful.
 
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