Question: A physical exam showed my fasting blood sugar at 116 and I was told I was pre-diabetic. A later check showed normal range. I have cut most sweets, white rice, potatoes, and bread from my diet and began walking an hour a day. My weight fell from 220 to 170 within six months without any effort on my part. I am 71 years old and am in good shape otherwise, but my toes, feet, fingers, hands, and arms tingle, and I wonder if my condition is worsening. My weight has stabilized at 170. I’m concerned.

Dr. Hibberd's Answer:

I share your concerns, but for different reasons. While your diet change is expected to provide some weight change, a 50 pound weight loss with such a simple change is highly unusual. Combined with your complaint of tingling in your arms and legs, I have genuine concern there are health conditions that need your immediate attention. While it is true that diabetes does cause neuropathy (unusual or diminished nerve function), it is usually seen after many years of full-fledged diabetes, not in those with borderline diabetes.

Neuropathy and its symptoms (such as tingling) associated with unintentional weight loss is a red flag for occult (hidden) malignancy. It may also be seen in chronic inflammatory conditions and in those with nutritional deficiencies. Neuropathy is less commonly associated with chronic infections and toxic states that are often associated with the use of medications and supplements. You are advised to review this with your doctor and perhaps request a referral to a neurologist to help explain the cause of your tingling. If no specific cause can be clearly identified, you will need further investigation.