Diabetic Neuropathy. Long Acting medication to help regulate sugar…

Posted by Nemo1 @nemo1, Mar 18 8:41pm

The neurologist today told me I have neuropathy and possible SFN during visit. I’ve been under the impression I had it, then didn’t, back again to having it. It’s sort of ridiculous. Going over my issues. Focusing on blood sugar. I could not understand why with consistent HbA1C at 6.7-6.9 my neuropathy symptoms are out of control.

While I know that is not a great HbA1C, I know it could be much worse.
My neurologist suggested I take glucose readings throughout the day, that it could be spiking.

Well, I’ve thought about it. I take 2000 mg (short acting due now to difficulty swallowing the horse pills - I grind them) Medication. The short acting (mentally just made the connection) Metformin not effective at managing spikes throughout the day. It may not be metabolized properly by my injured liver??? Thinking out loud, I digress. So, what I’m wondering is since I developed the swallowing problem in 11/21, I also fell and six months later developed what I can say now has been neuropathy all along.

I did not think for a second the original long acting Metformin I’ve taken since diagnosed with diabetes having been changed in 11/21 to short acting. Ive been on the short acting since that time and the neuropathy symptoms increased exponentially.

To my point (yes I have one lol), should I ask the endocrinologist I see in May (or maybe ask the pcp to get the ball rolling sooner) if someone would want to see if a different diabetic medication, a smaller pill easy to take - EFFECTIVE at regulating the glucose readings to be in line with what readings should fall under??

It can’t be a coincidence that neuropathy pains shot up since 2021 while being on the short acting which may have poorly controlled my numbers after meals. So, I am trying to nip it in the proverbial bud.

I am not a candy eater. My sweets are typically fruit. Most definitely consume plenty there and berries. I have sweets occasionally. No more. I have thought Ive controlled my sugars according to my fasting numbers. Well, ignorance is not bliss. Does anyone have any ideas about this?

🙏🏻

Ps: I’ve taken only a handful of readings over the course of being diabetic throughout the day, has primarily been fasting numbers have been around 115, throughout the day I’ve had them 180, over 200 thats all I remember.

Interested in more discussions like this? Go to the Neuropathy Support Group.

Nemo1 | @nemo1 | Mar 19 5:16am

Trying to reach an understanding about which L.A. (long acting) diabetes medications work well to control blood sugar over time, so that my post meal glucose reading (by 2 hours) is at 150 target.

I’m having awful diabetic neuropathy pains I’m trying to thwart by targeting blood sugar range over time.

I am not a candidate for Ozempic…

Any insights would be a bonus.

windyshores | @windyshores | Mar 19 7:42am

In reply to @nemo1 "Trying to reach an understanding about which L.A. (long acting) diabetes medications work well to control..." + (show)

Can you go on insulin? An insulin pump with CGM?

julbpat | @julbpat | Mar 19 7:52am

You could talk to your pharmacist about the large pill/swallowing problem - they might have a better idea. It’s an easy place to start anyway!

Justin McClanahan, Moderator | @JustinMcClanahan | Mar 19 8:52am

In reply to @nemo1 "Trying to reach an understanding about which L.A. (long acting) diabetes medications work well to control..." + (show)

Hello @nemo1 - I combined your two discussions on Diabetic Neuropathy into one, https://connect.mayoclinic.org/discussion/diabetic-neuropathy-long-acting-medicationto-help-regulate-sugar/, but gave them a dual home in the Neuropathy and Diabetes support groups. This will help members from both join your discussion and share their insights.

@nemo1, did I understand your post correctly when you mentioned you are seeing an endocrinologist in May?

Nemo1 | @nemo1 | Mar 19 9:52am

In reply to @windyshores "Can you go on insulin? An insulin pump with CGM?" + (show)

I didn’t really want to inject myself if at all possible. Im afraid I will give myself too much. I don’t know, would need to ask my dr if he would give insulin. I could maybe leave it as an option.

What is an insulin pump? What is cam? I need to google that. Thank you.

Thank you for your reply. I appreciate you sharing your thoughts.

Nemo1 | @nemo1 | Mar 19 9:57am

In reply to @julbpat "You could talk to your pharmacist about the large pill/swallowing problem - they might have a..." + (show)

I crush what I have. I am looking for a better, safer, more effective medication at regulating my blood sugar after eating. My history is that the numbers were higher but I didn’t think it was a big deal until the neuropathy caused a lot of problems. Sooo, I am looking for viable options outside of high doses of Metformin that work the kidneys hard.

Thank you for your reply! I appreciate your input 🙂

Nemo1 | @nemo1 | Mar 19 10:01am

In reply to @JustinMcClanahan "Hello @nemo1 - I combined your two discussions on Diabetic Neuropathy into one, https://connect.mayoclinic.org/discussion/diabetic-neuropathy-long-acting-medicationto-help-regulate-sugar/, but gave..." + (show)

Hi and thank you Justin!

I appreciate it.

Yes, I have an endocrinologist (new) in May. The old one is not working at that office or affiliated anymore so, the new endocrinologist. I had an appointment originally to follow my thyroid and look/watch the diabetes, but I will have dual purpose at that appointment.

Thank you again!

Nemo1 | @nemo1 | Mar 19 10:03am

In reply to @windyshores "Can you go on insulin? An insulin pump with CGM?" + (show)

At my rate of 2000 mg a day of metformin, would I even qualify, not being “insulin dependent”?

windyshores | @windyshores | Mar 19 10:56am

If you have neuropathy it would seem you need better treatment.

Insulin pumps have a background "basal" rate (adjustable) and a short acting "bolus" rate used for eating (dose based on carb count) and to correct highs (based on drop rate). Many pump users do a bolus some time before a meal to eliminate the high from the meal.

A CGM is a continuous glucose monitor, that gives a blood sugar reading on the phone every few minutes, gives a graph, and nowadays can connect to the pump in a closed loop system making some of the diabetes care automatic, though manual is always possible and often best.

Type 2's are starting to use these, I believe. Maybe ask your doctor!

Have you tried a low carb diet?

Nemo1 | @nemo1 | Mar 19 12:03pm

In reply to @windyshores "If you have neuropathy it would seem you need better treatment. Insulin pumps have a background..." + (show)

I will ask, thank you!

I have done low-er carb diet. I didn’t count or record. Just my blood sugar readings, blood pressure and weight. I guess that will not be enough anymore.

Right now I’m trying to change over to monkfish sugar (leaves an aftertaste) substitute instead on splenda (due to additives per the nutiricianist. She said monkfish or stevia. So dropped $10 on this monkfish. I will get the stevia next shopping trip. This stuff adds up.

I tried a severely modified Mediterranean diet, the doctor said it would help the inflammation. Could not handle all that fish and salads only. That is low carb I am not positive on that. I’d imagine it is with all that roughage. Lol

So, I gather low carb is the way to consume with blood sugar a little wonky?