Dear Dr. Roach: My husband is a 50-year-old prediabetic who has recently experienced burning feet. He refuses to think it’s his high-carb diet (bread three times a day, chips, ice cream) and instead thinks he just needs some vitamins for foot pain. Could you please explain why and how what he eats affects everything he’s experiencing? — Anon.
Answer: Diabetic neuropathy is a condition found in people who have had diabetes for years. It causes different symptoms in different people, but pain (often burning in character) and numbness are most common. The underlying cause is uncertain, but seems to be a combination of factors leading to nerve damage.
Prediabetes, often along with the other components of metabolic syndrome — including high blood pressure, excess abdominal fat and high cholesterol or triglycerides — may also bring on a neuropathy with very similar symptoms. Other causes, especially vitamin B12 deficiency, are appropriate to evaluate before determining the condition is most likely due to diabetes or prediabetes.