Diet and exercise are prescription

Dear Dr. Roach: My husband is a 50-year-old prediabetic who has recently experienced burning feet. He refuses to think it’s his highcarb diet and instead thinks he just needs some vitamins for foot pain. Could you please explain why and how what he eats affects everything? — Anon.

Diabetic neuropathy is a condition found in people who have had diabetes for years. It causes different symptoms in different people, but pain and numbness are most common. The underlying cause is uncertain, but seems to be a combination of factors.

Prediabetes, often along with the other components of metabolic syndrome may also bring on a neuropathy with very similar symptoms. Other causes, especially vitamin B12 deficiency, are appropriate to evaluate before determining the condition.

There are no specific treatments for the neuropathy, although there are medications to ease symptoms. Treatment of the underlying metabolic syndrome is therefore of the utmost importance, and the two most important treatments are diet and exercise. Avoiding simple carbohydrates is paramount. Regular exercise has an independent effect.

Your husband is at risk, and the fact that the symptoms are recent means he should look at this as a wake-up call. Changing his lifestyle dramatically now can lead not only to improvement in symptoms, but it will also reduce his risk of heart attack and stroke.

His doctor, a registered dietitian nutritionist and a diabetes nurse educator all are excellent potential sources of information. Vitamins do not help diabetic neuropathy. If he can start making the changes, I hope he will find, as most people have, that his quality of life and sense of well-being are so much better that he will not want to stop. Medications may be helpful, but the primary treatment is diet and exercise.

Write to Dr. Roach at ToYourGoodHealth@ med.cornell.edu or mail to 628 Virginia Dr., Orlando, FL 32803.