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Suggest Remedy For Tingling Sensation In Toes And Ankles In A Diabetic

Posted on Thu, 24 Dec 2015

Question: I am 63yo retired have had no major issues other than a bit of blood pressure and overweight. I have been diagnosed with diabetes type 2 last year I have been at pains to keep my blood sugar levels down to between 6 and 7. in The last two years I have developed a weakness in my legs to the extent that after I get out of bed or have been driving the car I have to hold on to something to steady myself for about 1 minute then I can then walk OK. It is a bit like when someone knocks you knee from behind and your not expecting it you almost collapse. I have ache in my hip and lower leg whilst lying in bed also. The left leg is worse than the right. I also get tingling and burning in the toes and a full feeling in the ankles. I have been tested for sensation on the feet and all checks out OK except for the big toe on left foot there is numbness around the first joint. I also feel a burning sensation on my right heel when I am driving and a t nightwhen I am flexing my feet in bed. I cant bear the thought of loosing the use of my legs

Answered by Dr. Dr. Muhammad Sareer Khalil (2 hours later)

Brief Answer:
Peripheral neuropathy, spine pathology

Detailed Answer:
Hello and Welcome

I appreciate your concern

Peripheral neuropathy is a complication related to long standing diabetes. After examination of the lower limbs that would include checking for tendon reflexes, muscle tone and strength, sensations and coordination. Based on the findings, imaging investigations such as an MRI of the spine can be advised if a spine pathology is suspected. If its diabetic neuropathy then strict glycemic control, lipid lowering, B 12 supplementation and pregabalin or gabapentin can be advised. Renal function tests , determination of proeteinuria via Urine Albumin to Creatinine Ratio, fasting lipid profile, CBC, Thyroid function tests and baseline ECG can be advised in consultation with your doctor. Doppler ultrasound of the lower limbs to look for patency of the vasculature can also be advised. Based on your description, there appears no imminent damage to your legs though the dreaded complications related to a herniated disc or inadequate blood flow should be avoided and be tested for, if relevant.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

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Dr. M.S. Khalil

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar