Itchy legs and BG

I'm a 64 year old skinny T2, diet and exercise only, two years
post-diagnosis.

Some time ago I posted the observation that over at least the last
fifteen years I've suffered from episodes of very itchy legs, the area
affected being the shin from just below the knee down to all around
the ankle area. Sometimes it would be very bad, sometimes mild. It
usually lasted for weeks, sometimes months. When it's bad I usually
scratch myself so much I end up bleeding. No doctor ever succeeded in
a prescription or suggestion which helped in any way other than
anaesthetising it.

Since I was diagnosed (and started lowering my BGs) two years ago, the
itchy episodes lessened greatly in both severity and duration, but
they still happened now and then. I never thought of a connection with
diabetes until someone here mentioned a possible connection. Then on
reflection, and looking back at some logs I keep, it looked to me as
though they might well have coincided with periods of high BGs.

Well, two days ago the itchy legs returned. I wasn't recording my BGs
(run out of strips) but I knew that they would have been worse than
usual because I've been suffering from a mild infection and cheering
myself up myself with some carby treats.

So I made yesterday an extremely low carb day. Breakfast was a baked
mackerel. Lunch was chicken soup with no starchy stuff and very litte
veg in it mostly just chicken scraps from boiled up carcasses. The
evening meal was venison stew with a few side veg, all non starchy,
much less than usual, less than the amount of meat. Oh, and I did have
a small plum, a small tomato, a glass of milk, and a few slices of
cheese as snacks. Far from a healthy diet, but as an experiment I was
trying to temporarily go really low carb to see what happened to the
itchiness.

And today the itchiness has gone! In one day! That's the most rapid
disappearance ever! It's never before lasted less than a week. and as
little as one week was very rare. Suggestive confirmation that high
BGs are the culprit. And useful and interesting to find that seriously
strangling the BGs effected such a rapid cure.

How high did my BGs go to provoke it? Being out of strips until I
visit my doc I don't know. On the basis of past experience I think I
was usually going over 150 one hour pps, but not much, and had been
doing so for at least a week before the itchiness developed. My usual
regime is that I aim for <140 one hour pp, and sometimes fail. My A1C
was last measured at 5.4%, and since then my BGs have improved.

--
Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

On 8-Nov-2006, Chris Malcolm <cam@holyrood.ed.ac.uk> wrote:

> Some time ago I posted the observation that over at least the last
> fifteen years I've suffered from episodes of very itchy legs, the area
> affected being the shin from just below the knee down to all around
> the ankle area. Sometimes it would be very bad, sometimes mild. It
> usually lasted for weeks, sometimes months. When it's bad I usually
> scratch myself so much I end up bleeding. No doctor ever succeeded in
> a prescription or suggestion which helped in any way other than
> anaesthetising it.

Hi Chris,

I had the same problem with what I called "diabetic dermatitis" for months
before and after diagnosis. I also had a chronic fungus on my right ankle. A
friend who is a nurse specializing in diabetic cases and a diabetic educator
with Sentara Norfolk General Hospital advised me that the itchy and bleeding
shins were a common problem for diabetics, especially for T2s whose blood
sugar is chronically elevated.... She advised that getting the BG under
control would improve the skin condition on my legs. After I lost
significant weight last year and achieved tight control of my BG by exercise
and going low carb, the skin and fungus problems cleared up. As targets to
aim for, she suggested aiming for < 90 for the FBG and keeping it under 125
after eating, or not much more than that, if possible. Of course, the
consensus on here is < 140 pp.

Your experience and mine are interesting confirmation of how sensitive our
tisses are to damage from elevated glucose levels.

Will, T2

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On Wed, 08 Nov 2006 10:57:08 +0000, Chris Malcolm wrote:

> I'm a 64 year old skinny T2, diet and exercise only, two years
> post-diagnosis.
>
> Some time ago I posted the observation that over at least the last
> fifteen years I've suffered from episodes of very itchy legs, the area
> affected being the shin from just below the knee down to all around
> the ankle area. Sometimes it would be very bad, sometimes mild. It
> usually lasted for weeks, sometimes months. When it's bad I usually
> scratch myself so much I end up bleeding. No doctor ever succeeded in
> a prescription or suggestion which helped in any way other than
> anaesthetising it.
>
> Since I was diagnosed (and started lowering my BGs) two years ago, the
> itchy episodes lessened greatly in both severity and duration, but
> they still happened now and then. I never thought of a connection with
> diabetes until someone here mentioned a possible connection. Then on
> reflection, and looking back at some logs I keep, it looked to me as
> though they might well have coincided with periods of high BGs.
>
> Well, two days ago the itchy legs returned. I wasn't recording my BGs
> (run out of strips) but I knew that they would have been worse than
> usual because I've been suffering from a mild infection and cheering
> myself up myself with some carby treats.
>
> So I made yesterday an extremely low carb day. Breakfast was a baked
> mackerel. Lunch was chicken soup with no starchy stuff and very litte
> veg in it mostly just chicken scraps from boiled up carcasses. The
> evening meal was venison stew with a few side veg, all non starchy,
> much less than usual, less than the amount of meat. Oh, and I did have
> a small plum, a small tomato, a glass of milk, and a few slices of
> cheese as snacks. Far from a healthy diet, but as an experiment I was
> trying to temporarily go really low carb to see what happened to the
> itchiness.
>
> And today the itchiness has gone! In one day! That's the most rapid
> disappearance ever! It's never before lasted less than a week. and as
> little as one week was very rare. Suggestive confirmation that high
> BGs are the culprit. And useful and interesting to find that seriously
> strangling the BGs effected such a rapid cure.
>
> How high did my BGs go to provoke it? Being out of strips until I
> visit my doc I don't know. On the basis of past experience I think I
> was usually going over 150 one hour pps, but not much, and had been
> doing so for at least a week before the itchiness developed. My usual
> regime is that I aim for <140 one hour pp, and sometimes fail. My A1C
> was last measured at 5.4%, and since then my BGs have improved.

I have observed a 'strange sensation' in my left heel when BG is above my
target range. It's not quite numbness, not quite an itch - often an
external dryness. When my BG is under control, it is much less noticeable.

"Chris Malcolm" <cam@holyrood.ed.ac.uk> wrote in message
news:4rdrg4FqjgjdU1@mid.individual.net...
> I'm a 64 year old skinny T2, diet and exercise only, two years
> post-diagnosis.

Hi Chris,
I'm a 60 year old skinny T2 , diet and exercise only, two years
post-diagnosis.In my case I have a lot of neuropathy.Symptoms : pain in my
hands and feet , numbness in other places.

I am lucky to have a very good neurologists. Close to his pension , very
knowledgable maybe a bit cynical now and than , much humor.He kindly
explained to me that medicine wants to put everything in nice little boxes
to keep control.Which I knew already ofcourse

So there is a box "nerve" , a box "vein' a box "muscle" etc , etc. But in
the real world these things are all interconnected in the living entity
"leg" and "human being" ofcourse.So the nerve commands the vein to open or
close.If the nerve is damaged by T2 than this process can go wrong.The nerve
commands the vein to close at a temperature which is far from dangerously
low. And you get very cold feet at night.Which I have.Which my neurologist
diagnosed as Raynaud Disease and has nothing to do with my diabetes but with
my old smoking habit.Or my cold feet could be caused by Peripheral Artery
Disease (PAD) which is caused by the damage of the small arteries by the
high bg. Thus by diabetes T2. If the arteries are damaged than the nerve
cells will not get enough blood and food so they will get damaged.So you
will get pain or itch or nubness.He explained to me that inorder to diagnose
PAD you would have to look at the small periferal arteries only.Not just at
the large veins with the ankle brachial test.This diagnose involves NMR
after ingesting something to make the small arteries visible.So .... to
expensive So he just did it the otherway around ; nice guy , I like his
approach . Gave me something to help the PAD .Beraprost , a
prostaglandin.Prostaglandins are vasodilators; they improve blood flow by
relaxing smooth muscles and opening the blood vessels.See if it helped . If
it did , problem over. Much less expensive than the NMR test.I took the
medicine for about 2 weeks , did not help much , so stopped If you
become more physical active than the muscle movement will stimulate the
bloodflow in your legs , this will activate the growth of new small arteries
, this will help the process of cleaning up the dead nerves and you will
feel less pain , itch , numbness.

So nerves , arteries , muscles are just the "boxes" you better look up them
as closely interconnected things living together in your legs. I liked my
neurologist explanation.

He also has a mechanism :
the chronical high glucose over years will cause a chronical high glucose
concentration in your nerve cells.One of the first steps in the metabolism
of glucose , after it enters a cell , is its conversion to sorbitol.Now
sorbitol is a small molecule and , as opposed to glucose itself , there are
no active transporters for the sorbitol molecule.So all the sorbitol is now
trapped in the nerve cell.The nerve cell will swell because of the too high
osmotic pressure (Science again <gggg> ) and the nerve cell will get
damaged. Another cell would just die and you would notice nothing.This is
ofcourse different with a nerve cell because it was made by nature to signal
you that something is wrong.So depending on a lot of things you can feel :
pain , numbness , itch etc. I mostly feel pain in my hands and feet and
numbness in other parts of my body.

> Some time ago I posted the observation that over at least the last
> fifteen years I've suffered from episodes of very itchy legs, the area
> affected being the shin from just below the knee down to all around
> the ankle area. Sometimes it would be very bad, sometimes mild. It
> usually lasted for weeks, sometimes months. When it's bad I usually
> scratch myself so much I end up bleeding. No doctor ever succeeded in
> a prescription or suggestion which helped in any way other than
> anaesthetising it.

Sorry to hear that Chris,sounds very painfull.....

> Since I was diagnosed (and started lowering my BGs) two years ago, the
> itchy episodes lessened greatly in both severity and duration, but
> they still happened now and then. I never thought of a connection with
> diabetes until someone here mentioned a possible connection. Then on
> reflection, and looking back at some logs I keep, it looked to me as
> though they might well have coincided with periods of high BGs.

I found the same thing but in my case the damaged nerve cells want to signal
lots of pain to me instead of "itch".Well pain and itch .... would not know
what is worse ; just a joke

> Well, two days ago the itchy legs returned. I wasn't recording my BGs
> (run out of strips) but I knew that they would have been worse than
> usual because I've been suffering from a mild infection and cheering
> myself up myself with some carby treats.
>
> So I made yesterday an extremely low carb day. Breakfast was a baked
> mackerel. Lunch was chicken soup with no starchy stuff and very litte
> veg in it mostly just chicken scraps from boiled up carcasses. The
> evening meal was venison stew with a few side veg, all non starchy,
> much less than usual, less than the amount of meat. Oh, and I did have
> a small plum, a small tomato, a glass of milk, and a few slices of
> cheese as snacks. Far from a healthy diet, but as an experiment I was
> trying to temporarily go really low carb to see what happened to the
> itchiness.
>
> And today the itchiness has gone! In one day! That's the most rapid
> disappearance ever! It's never before lasted less than a week. and as
> little as one week was very rare. Suggestive confirmation that high
> BGs are the culprit. And useful and interesting to find that seriously
> strangling the BGs effected such a rapid cure.

I found the same effect.
Nice to see that this also works for you.

On those days I tend to restrict food to sardines , wallnuts , broccoli
maybe a glass of red wine. Sometimes I realise that my carbohydrate intake
in the day before was much too high.Too much treats.So too many calories in
the first place.So on some days I live on water and exercise only .
Gather-Hunter diet Time to catch a mammoth , no food around today.
Makes me feel optimistic , in control and happy for some reason. This has a
very big impact on my neuropathy : alsmost no pain left in my hands and feet
!!!! Unbelievable !!!!

> How high did my BGs go to provoke it? Being out of strips until I
> visit my doc I don't know. On the basis of past experience I think I
> was usually going over 150 one hour pps, but not much, and had been
> doing so for at least a week before the itchiness developed. My usual
> regime is that I aim for <140 one hour pp, and sometimes fail. My A1C
> was last measured at 5.4%, and since then my BGs have improved.

I also aim for < 140
I sometimes fail very miserably
My last A1c was 5.0 %

Hope you keep posting here Chris . I read all your posts
I like your very precise formulations and humorous style

Gys