Brief Answer:
need further details

Detailed Answer:
Dear

Thanks for contacting with your health query and following points need further information from your side for better management and understanding.

1. Please let me know about your uric acid values since high uric acid can be due to
. overproduction [uric acid value, high protein diet] or
, under excretion [renal function test reports]

2. Fatty liver is due to any addiction or because of some metabolic disorder?

3. Is deficiency of both vitamins independent of one another or is linked with each other
PS. Most common causes of simultaneous lack of both vitamins is/are:
Indoor jobs, lack of exposure to sunlight, vegetarian lifestyle, stress, pollution, poor diet, are the main cause for Vitamin D3 and B12 deficiency among the urban population, do let me know about any such possibility?

4. Please let me know about your blood pressure readings:

A
. Have you checked with your Lipid- Blood sugar and Thyroid Profile for any cardiovascular risk factor of blood pressure??
PS.
. although sugar is high which is one aggravating factor for the same
. pre hypertension is more common in men then in women and any family history of the same.
. Weight : please let me know about your weight [which is a controllable risk factor].
. Addiction [alcohol, smoking, salt intake]?? or use of medications like: cold remedies,decongestants,pain killers
. Physical Lifestyle: is it Sedentary or Active?

B
Did you check with your Health care professional for the same? and did you observed it at SAME time of the day [because reading changes throughout the day]?

5. For Diabetes
1. say NO to: Sugar, all sweets, cakes, sweetened biscuits-drinks, sweet fruits like mangoes and grapes, jam,honey, canned sweet fruits.
2. Eat in Plenty: all leafy vegetables, tomato, cucumber, brinjal, cauliflower, lady's finger, soup [tomato/vegetable], butter milk, sugar free drinks, tea/coffee with sweeteners, all cereals, sprouted pulses.
3. Eat restricted quantities: chapati, bread, corn flour, plain or salted biscuits, rice, meat, eggs, chicken, fish, skimmed milk.
4.
. Regularize timings and quantity of meals.
. be careful in festivals and marriages, compensate for extra sweets by reducing previous and subsequent meals.
. do not remain starving for long periods.
. avoid alcoholic drinks.
5. wash the feet daily, dry them, inspect them & then sprinkle lot of talcum powder.
. avoid walking barefoot, even at home.
. wear soft cotton socks and canvas shoes, avoid tight fitting shoes and chappals. . cut nails carefully and always after bath, when they are soft.

PS. what to look for clinically A.
1. Weight
2. blood pressure [must be checked on every visit]
3. Check peripheral pulses on the legs [even if the patient does not have any leg complaints]
4. Examine the feet: especially the inter digital spaces and soles, for infections, ulcer and sensory loss.

Do revert back for further necessary Management.

Dr. Munish Sood
Consultant & Physician
Naimittika Clinic

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