10/08/2026
"Watch your sweets."
With all due respect to his provider, that’s not a plan…especially for someone whose feet feel like they’re on fire every single day.
This is exactly what came up during today’s consult.
Here's what his labs actually showed:
• A1c: 6.0% (prediabetes range)
• Fasting insulin: 19.7 (2-5 is optimal)
• Triglycerides up, HDL down, liver enzymes off
He's been on more than one nerve pain medication for it. No help.
Somebody needs to hear this:
NERVE DAMAGE DOES NOT WAIT FOR A DIABETES DIAGNOSIS.
Most people think "prediabetes" means nothing is happening yet. Don’t be fooled. Diabetes is a disease process…100%.
A 2021 review of 29 studies found more nerve damage in people with prediabetes than in the general population, mostly in the small nerve fibers, which are the ones that burn, tingle, and keep you up at night.
In one JAMA Neurology study, neuropathy showed up in 29% of people with obesity and prediabetes. In lean, healthy people? About 4%.
It's not just sugar. It's the whole metabolic picture…
High insulin, a growing waistline, high triglycerides, low HDL.
When insulin is working that hard (4X harder than it’d like to) just to keep your glucose "normal," your nerves, liver, and heart are paying the cost.
His glucose was 96, which looks…well…”fine.” And it only looks “fine” because his insulin was cranked up to hold it there.
To be clear, nerve pain can have more than one cause. But when the numbers line up like this, insulin resistance is the most likely driver and the most fixable one.
Meds for nerve pain can quiet the symptoms, but it won't touch what's stirring underneath it all.
The good news? He's already moving:
• No more sweet tea or soda
• No more alcohol
• Daily walks, now with weight added and a 10-minute walk after meals
• A targeted plan to bring insulin down, plus omega-3s, which his labs showed were very low
We're retesting in 90 days. And I’m pumped to see where things land.
The point: If your feet burn and nobody has looked at your fasting insulin, ask for it. If your A1c is "only" 5.8, 5.9, 6.0 and the entire plan is "watch your sweets," you deserve something real.
-EB
