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Feet pains - Can't sleep - HELP

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Sean

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Relationship to Diabetes
Type 1
Firstly, apologies for not coming on here sooner. After living with diabetes for 14 years it really is time I sort it out. Now I'm starting to experience some problems common with bad control.

I have terrible pain in my feet, which magnifies itself at night. It's a difficult pain to describe, but it's almost as if i've been wearing shoes 3 times too small really tight for a day. I feel this pain when I'm not wearing any shoes at all! And I know my shoes are plenty big enough. I've never been on a long haul flight, but i'd imagine it feels similar to that of dvt that you hear about.
I do get the occasional shooting pain.
It can be painful during the day, but at night its at it worst and is preventing me having half a tidy nights sleep.
I went to the diabetic unit on monday (I hadn't been for years, yes hang my head in shame!). He said it's due to bad control of diabetes. He's adding some tablets to my pescription. From what I can gather they're a mild form of anti - depressant, so i'm a bit weary of that.
Can any of you help me to understand this, is there anything I can do to ease the pain? Should i go into the garage and cut my legs off? 😱
 
Hi Sean, welcome to the forum 🙂 Very sorry to hear about the problems you are experiencing :( It sounds very much like peripheral neuropathy, which is nerve pain associated with poor diabetic control. The drugs you have been prescribed, although a form of anti-depressant, are commonly given to help treat this condition so don't be concerned about the depression angle.

Did the diabetic unit give you any other form of support? Have they arranged blood tests so you can find out where you stand? I'm glad you have joined - hopefully we can help you to get things under control. There is a possibility that your nerve pain will ease if you can improve your blood sugar control, so you have everything to gain and nothing to lose!

Might I suggest that, although you have been diagnosed for many years, you look upon this as though you are new to diabetes? Put the past behind you and start afresh! I would recommend getting a copy of Type 2 Diabetes: The First Year by Gretchen Becker so you can learn to look at your diabetes in a new light. What medication are you on, and when was it last reviewed? Do you test your levels at all, and do you know what your HbA1c is? Please feel free to ask any questions you may have. There are lots of lovely, friendly and knowledgeable people here who can empathise and will do their best to help you find a healthier and happier you! 🙂
 
Can't add a lot to advice already given, but wanted to say welcome to the forum.

There are many patient education classes, so it may pay to see if you can get into one. You might find you know lots of things already but there are someuseful reminders and I found it helps to meet other people with diabetes too.

Your clinic or GP should have information about courses local to you or some are advertised in places like the local library.
 
Hi Northener, thanks for your reply.
I had blood tests 6 weeks ago. HB1ac was 10.something she said, although I have no idea what that means.
I'm awaiting a letter to be refered to have my eyes looked at, and I've got a new meter to test my sugars (I lost my old one). The nurse is giving me a call next week to see how i'm gettin on. Next review is in 4 months.
I take lantus in the morning and I take humalog for every meal.

Thanks Caroline - I'll see what i can find out about anything happening locally 🙂
 
Hi Sean, well done for deciding to take control of things. If your HbA1c is 10 then you will need to focus on bringing that down to a more acceptable level. Take things slowly and don't expect a perfect result next time. Mine is 7.5 which is reasonable but not perfect! The pain in your feet sounds horrible and I hope that something can be done to ease it for you. It's good that the nurse is keeping an eye on you, I hope that continues so that you are not left to "get on with it" until your next review. All the very best.
 
Sean said:
Hi Northener, thanks for your reply.
I had blood tests 6 weeks ago. HB1ac was 10.something she said, although I have no idea what that means.
I'm awaiting a letter to be refered to have my eyes looked at, and I've got a new meter to test my sugars (I lost my old one). The nurse is giving me a call next week to see how i'm gettin on. Next review is in 4 months.
I take lantus in the morning and I take humalog for every meal.

Thanks Caroline - I'll see what i can find out about anything happening locally 🙂
Click to expand...

Hi Sean, sorry I recommended a Type 2 book to you - as you are a Type 1 the best book to get is Type 1 Diabetes in Children, Adolescents and Young People by Ragnar Hanas. It is a very comprehensive and well-written book dealing with all aspects of Type 1, and you may be surprised at what you might learn 🙂 Make sure that you test your blood sugar levels efficiently. Test,Review, Adjust by Alan S is a good guide - you need to determine how different meals affect you so you can see where you might need to make modifications. Do you carb count? If not, you should ask if there are any courses in your area.
 
No I don't carb count. I have heard about a course called DAFNE i think its called. Do you know if this is any good?
 
Hi - is the medication Amitriptyline ? this is used for both neuropathic pain and in higher doses as an anti-depressant. (There is also Duloxetine which is both an anti-depressant and px'd for diabetic neuropathy which is a bit newer and more expensive) My hubby takes the former for neck pain (referred nerve pain down shoulders and arms) from a rugby injury few years back, had tried various other analgesics and this has been most successful, also the added bonus of a good nights sleep he has found. So please don't be wary, these medications are very effective from both personal and professional experience and certainly worth a trial.
 
Sean said:
No I don't carb count. I have heard about a course called DAFNE i think its called. Do you know if this is any good?
Click to expand...

If you can get on a DAFNE course, then it would be great. I would ask your nurse what is available in your area - they may have DAFNE or they might have their own local variation. Have alook at Diabetes UK's free download to give you an idea of what it's about:

http://www.diabetes.org.uk/OnlineSh...diabetes/Food-and-activity/Carb-count-e-book/

There's also an online carb-counting course that is very good:

http://www.bdec-e-learning.com/

🙂
 
Thanks Northener, massive help.
In the meantime is there anything I can do to improve the pain? anything I can do to improve circulation?
 
Hi Sean

For what it's worth I had a lot of foot pain just after diagnosis. Luckily for me I got good control fairly quickly and it healed and I've not had it now for years. I hope the same happens for you.

Northerner has given you a link to the online carb counting course. I highly recommend it. I did it and by the time I actually got some "real life" carb counting education I really didn't need it, I learned little that I didn't already know from doing the online course. It's so important to be able to match your rapid acting insulin to the carbs you eat. Once you get going you'll wonder how you ever managed before.
 
Sean said:
Firstly, apologies for not coming on here sooner. After living with diabetes for 14 years it really is time I sort it out. Now I'm starting to experience some problems common with bad control.

I have terrible pain in my feet, which magnifies itself at night. It's a difficult pain to describe, but it's almost as if i've been wearing shoes 3 times too small really tight for a day. I feel this pain when I'm not wearing any shoes at all! And I know my shoes are plenty big enough. I've never been on a long haul flight, but i'd imagine it feels similar to that of dvt that you hear about.
I do get the occasional shooting pain.
It can be painful during the day, but at night its at it worst and is preventing me having half a tidy nights sleep.
I went to the diabetic unit on monday (I hadn't been for years, yes hang my head in shame!). He said it's due to bad control of diabetes. He's adding some tablets to my pescription. From what I can gather they're a mild form of anti - depressant, so i'm a bit weary of that.
Can any of you help me to understand this, is there anything I can do to ease the pain? Should i go into the garage and cut my legs off? 😱
Click to expand...


"mild form of anti-depressant" - I'm guessing, but you probably mean a low dose of amitriptyline. At higher doses, it is an anti-depressant, but at lower doses at night, it treats certain types of pain, particularly nerve pain / neuropathy - see http://www.painconcern.org.uk/2011/04/leaflets/amitriptyline
 
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