Question: Dear Doctor,
I am furnishing my old question with your answer, as I need one more advice on my existing problem please.

“MY OLD QUESTION”

"I am diabetic & BP & it is under moderate control with medication and Insulin. My diet also is as per advise and it is include mixed vegetables (boiled & Raw) and fruits.

Brief Details:-

Diabetic (Type -II) - 18 Years
BP - 10 Years

• Vegetarian
• Non-smoker
• Non-alcoholic
• Age – 53 Years
• Weight 79.7 Kg
• Height 176 CM

Medications prescribed on 22-02.2012 are:-

TAB- METAFORTE G-853 1-0-1
INJ - MIXTARD 30/70 16-0-8
TAB - TELSARTAN AM 40MG 1'-0'-1
COLSPRIN 100 MG 1'-0'-0
TAB- PLOZ MF -15 0'-1'-0
TAB- ROSEDAY 10MG 0'-0'-1
BECADEXAMIN 0-0-1

Presently my BP and Sugar are under moderate control with changed medicines:
I have taken my annual checkup during Feb 2012 and attaching the summary of the reports herewith sir.

My present problems are: -

(1) Head ache: - Since one year (ever little more) I am having headache. It is on my left side of my forehead. In-fact today also I am having this problem and my BP was 120/77 during morning and sugar was 144 RBS and now presently having BP is 119/74. – I got my eye checkup also and confirmed that cause of headache is not due to eye sight. Due this headache I normally feel to take hot coffee and use headache balm.


(2) Mussel pain, especially “Sudden Catch” during night in Knee portion (above heel) and it is once in a month or so during night and when I get this “catch” immediately I will get up and shake my leg and next day morning it will be normal – is it a matter of concern sir?

(3) Pain in my leg and especially more pain in my Heel portion (diabetic neuropathy). I am managing with MCR sole shoes with silicone gel pad. Is there any chance of reversing this neuropathy pain sir?

Physical Activity:-

45 Minutes to One Hour walking daily (But now days due these problems I am not very regular)


Details of My food intake are: -

7.00 AM - Coffee and two Biscuit (WITHOUT SUGAR)
8.30 AM - Half cup coffee
9.30 AM - Two Chapatti with two cup Raw & boiled vegetable, D-Protin without milk.
11.00 AM - Half cup coffee with two Biscuits
12.00 No - One Fruit like orange, sweet lime etc
12.45 PM - Half cup coffee
01-30 PM - One small cup rice with sambar & Two cup boiled & raw vegetable
3.00PM - Half coffee with two Biscuits
4.30 PM - Half coffee again
6.30 PM - Half coffee and two biscuits
8.00 PM - Raw vegetable (one cup)
10.00 PM - One cup rice with Sambar & Curd with little raw vegetable.


Nature of Work

Desk work with normal work related stress and I can say it is in the higher side, normally I have good sleep and once in a week or so I will have disturb sleep.

Expecting your kind & expert advice sir,

Thanks and regards,
XXXXXXX

Doctor's reply to your question above...
Hi,

Thanks for your query.

First, I would like to appreciate your detailed history.It helped me to understand your problem much better.Thanks for the same.

As per my understanding the basic illness in you like Hypertension and Diabetes are in good control and the problems you have are not direct effects of these illnesses except neuropathy in foot.

The problems, Headache and muscle cramps and spasms in you are mainly due to the drugs you are taking.These side effects do start suddenly on initiation of the dose and more often over long term use developing slowly.

Specially medications like Pioglitazone (in PLOZ MF), Rosuvastatin (in ROSEDAY) are the culprits.Well known and commonly encountered side effects of these drugs are headache, muscle cramps, sinusitis, sore throat etc.

Symptomatic treatment as you are already taking would suffice.If the problems cross the comfort zone then you may have to consult your treating doctor for revision of the medications.

The diabetic neuropathy you are diagnosed with is of moderate severity , Multivitamin supplements would be much sufficient for such a presentation.Steroids are mainstay treatment in neuropathy but as they cause rise in sugar levels their use for such a cause is based risk benefit ratio.

Hope I have answered your query. Let me know if I can assist you further.

Wish you good health.

Regards,
Replied by Dr. XXXXXXX A.T , 22 hours ago

And my present problem:-

Sir, I am having the “ED” problem since more than a year and with this present health problems and medicines , sir, do you advice me to take any tablet for my ED problem and if yes could you indicate me the name of the tablet and dosage please

Thanks and regards,
XXXXXXX

Thanks Doctor and noted your advice sir, also could you please explain me whether peripheral neuropathy can cause HEEL PAIN sir, since I am having heel pain after my morning walk and that too in my left leg sir?

Sir, is there any special type of running shoe are available for diabetics, at present I am using shoes with MCP/MCR sole with Silicon gel pad sir, but still do you think this shoe is causing heel pain sir?

Thanks and regards,
AAAAA