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What Causes Lightheadedness And Numbness In The Extremities While Having Diabetes?
Question: A friend, who has type I diabetes and a heart condition (unspecified) has been experiencing episodes of lightheadness upon standing, and loss of circulation at night. He wakes up cold and his extremities fall asleep. A year ago, he was told that he should have test to rule out carotid artery disease, but still has not had it. We know you cannot provide a diagnosis, but what would you be looking if he were your patient?
Brief Answer:
Diabetes
Detailed Answer:
Sorry to learn about your friend's bothersome symptoms.
He must make sure it is not hypoglycemia ie a low blood glucose reaction, or low blood pressure. If he has someone around him at the time symptoms occur, the other person can check both these with the help of a glucose monitor and a digital blood pressure machine
He will benefit form the services of a Neurologist and Cardiologist to rule out the possibility of Autonomic Neuropathy and 'orthostatic hypotension. These are medical terms for a complication of diabetes that affects nerves of the heart and circulation, leading to symptoms like the ones your friend is experiencing.
When I see someone like him in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies 12 hour Fasting Lipid profile
Urine albumin to Creatinine Ratio (early sign of diabetes affecting the kidney)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Diabetes
Detailed Answer:
Sorry to learn about your friend's bothersome symptoms.
He must make sure it is not hypoglycemia ie a low blood glucose reaction, or low blood pressure. If he has someone around him at the time symptoms occur, the other person can check both these with the help of a glucose monitor and a digital blood pressure machine
He will benefit form the services of a Neurologist and Cardiologist to rule out the possibility of Autonomic Neuropathy and 'orthostatic hypotension. These are medical terms for a complication of diabetes that affects nerves of the heart and circulation, leading to symptoms like the ones your friend is experiencing.
When I see someone like him in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) Thyroid autoantibodies : Anti Thyroid Peroxidase (TPO) antibodies and Anti Thyroglobulin antibodies 12 hour Fasting Lipid profile
Urine albumin to Creatinine Ratio (early sign of diabetes affecting the kidney)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks. I have been trying to persuade him to see an endocrinologist. He has not seen one in 2 years. He is very intelligent and often succeeds in convincing caring friends and relatives that he is making informed decisions when he is most likely avoiding the truth. What are the most important points that I can make in suggesting that he really should be seeing endocrinologist as well as family doctor?
Brief Answer:
Follow up
Detailed Answer:
This can be a life threatening condition. That is the key statement and fact of the matter
Follow up
Detailed Answer:
This can be a life threatening condition. That is the key statement and fact of the matter
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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