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February 24, 2002


Question from Newcastle upon Tyne, England:

I am 28 years old, and have had type 1 diabetes for about 17 years. My diabetes has been severely brittle for the past 10 years, and about six years ago, I was diagnosed with peripheral and autonomic neuropathy. For the past month, I have been taking metformin since my body is rejecting the insulin, but still my blood sugars are running between 25-40 mmol/L [450-720 mg/dl]. The pain I am suffering is unbearable, even though I am taking three pain medications, and my doctor has told me this is a terminal condition. I have had many hospital admissions. Is there any other treatment available for my condition? I have very little knowledge of what is happening to me and would be grateful for any information you could give.


I am sorry you are having such a rough time of it. Painful neuropathy can be a disabling condition with diabetes.

Of the medications you are on, there are still several that have also been effective against painful neuropathy, including the drug gabapentin (trade name Neurontin). Good blood sugar control will also help with the neuropathy. If your sugars are not well controlled, you may try more aggressive therapies, with avoidance of low sugars.

I am not sure it is a terminal condition. I do not know exactly what that implies. Clearly, painful neuropathy may run its course and spontaneously improve. I would not be willing to state nothing else can be done without knowing more specific details about your case. Unfortunately, that is a limitation of this medium. I would recommend you discuss these issues with your physician so that you can understand more fully what is happening.