Maybe there's an underlying condition? I always pooh poohed my prediabetes label because my A1C was close to normal but I was overweight most of my adult life and didn't get enough exercise. It's only been the past few years that I've made some changes to eat and live a healthier lifestyle. I've been reading up on metabolic syndrome which can cause lead to a lot of different diagnoses and recently read an article from 2016 that may be what's going on with my idiopathic small fiber PN diagnosis.

"Is small fiber neuropathy fatal? — When those deposits build up, peripheral nerves start to malfunction, and the patient experiences peripheral neuropathy. The disease eventually involves sensory, motor and autonomic nerves, and it is fatal.” — The Fire Within – Johns Hopkins Medicine: https://www.hopkinsmedicine.org/news/publications/hopkins_medicine_magazine/features/fall-2016/the-fire-within

Metabolic Syndrome | NHLBI, NIH: https://www.nhlbi.nih.gov/health-topics/metabolic-syndrome