DEAR DR. ROACH: I have peripheral neuropathy symptoms in my feet. I am borderline diabetic and keep it under control by eating right. Also, my legs are weak, and I am doing exercises. I was taking the drug Reglan for a couple of months. During the time I was taking it was when I started to have these leg problems. Could this be a side effect of the Reglan? — G.D.
ANSWER: Diabetic neuropathy is a complication of longstanding diabetes, especially if it has been poorly controlled. Occasionally, it can show up seemingly early in the course of Type 2 diabetes, but this is thought to represent a delay in diagnosis in otherwise asymptomatic disease or in those who have ignored symptoms. The symptoms of diabetic neuropathy usually begin with numbness, and later on pain and tingling of the feet. Weakness, when it happens, generally comes later on.
Metoclopramide (Reglan) is used for nausea and vomiting, especially after chemotherapy, and is used to stimulate the stomach emptying in people with diabetic gastroparesis, which is a type of neuropathy of the nerves to the stomach and intestines. Many or most diabetics with gastroparesis also have diabetic neuropathy. However, metoclopramide should not be given for more than eight weeks due to the risk of tardive dyskinesia, a serious disease of motor control, especially in the facial muscles. Although tardive dyskinesia can cause symptoms in the limbs, weakness would be unusual, and tardive dyskinesia would be very unusual if you took the Reglan only for two months and have stopped.
I think it is unlikely that either diabetic neuropathy or the Reglan are causing the muscle weakness. There are many kinds of neuropathies, and all (or nearly all) are more common in people with diabetes. I would revisit your doctor to try to find out more about why you are having leg weakness.
READERS: Diabetes has become epidemic in North America. The booklet on it offers insight into its diagnosis and treatment. Order a copy by writing: Dr. Roach — No. 402W, 628 Virginia Drive, Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. ROACH: We always hear about “superfoods” and their antioxidant power. Is there any truth to the hype? — H.C.
ANSWER: I know what you are saying; blueberries, kale and acai berries often are called “superfoods.” I don’t really know what “superfood” means. These foods are generally healthy, as part of a balanced diet, but it doesn’t mean that eating them can make you live forever — or even erase bad food choices.
To me, a healthy diet is one with lots of diversity
— many different fruits, vegetables, nuts, whole grains and fish and limited amounts (or none) of red meat, saturated fat and processed foods. Health isn’t found by sticking to a fad diet, but by a lifetime of healthy eating, regular exercise, stress reduction, good social interactions and being fortunate enough to avoid injury and disease. Making good choices dramatically improves your odds of a healthy life.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med. cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
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