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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Ulcers In The Lower Legs In Diabetes?

My husband is 72 years old. Diabetes type 2 and heart patient. Had open heart surgery about 5-6 years ago. Triple bypass and carotid artery surgery at the same time. He also has high blood pressure still while being on two different types of meds for the blood pressure. He takes insulin twice a day. Sugars still run 200+. As you probably have gathered, he is not a compliant patient at all. Lately, he has been dealing with ulcers on his lower legs due to the fluid buildup and diabetes, so he has been seeing a wound specialist for that. He will not exercise, due to pain in the knees. He is 6 1 and weighs 260lbs. Eats and drinks what he wants. You get the picture I m sure. My question is, is there a site that I, as his caretaker, can go to for support for myself? I find myself angry with him because he could control all of this if he wanted to then I feel guilty feeling that way. He does work part-time, sitting at a desk answering phones and dispatching. Thanks
Tue, 26 Aug 2014
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Diabetologist 's  Response
Dear Madam,
Welcome to HCM
I understand your concern. Let us go step by step. You have a patient who is not willing to take care of himself. Most common reason is he is under some kind of depression due to his health issues. Depression in males is very difficult to find out as males generally do not express their mood swings too easily. Here having 200+ blood sugars is never good. As a first step it would be nice to get a diabetes counselor/ Psychologist involved. it has to be emphasized that having high sugars with heart problems is gonna give him a painful life ahead. Next step is to concentrate on his diet. I presume that you might be facing trouble controlling his snacking. So slowly you can reduce his card intake. At one point he will come down slowly on sugars, At this point we can adjust his dosage of medicines. Right now you have mentioned only about insulin. I would prefer to have my patients on metformin as well. This will make their body more responsive to insulin. I know what i am telling you now cannot happen overnight. But for a better and long term successful management these steps are essential.
Hope i have answered your query
Dr.Riyaz Sheriff
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How To Treat Ulcers In The Lower Legs In Diabetes?

Dear Madam, Welcome to HCM I understand your concern. Let us go step by step. You have a patient who is not willing to take care of himself. Most common reason is he is under some kind of depression due to his health issues. Depression in males is very difficult to find out as males generally do not express their mood swings too easily. Here having 200+ blood sugars is never good. As a first step it would be nice to get a diabetes counselor/ Psychologist involved. it has to be emphasized that having high sugars with heart problems is gonna give him a painful life ahead. Next step is to concentrate on his diet. I presume that you might be facing trouble controlling his snacking. So slowly you can reduce his card intake. At one point he will come down slowly on sugars, At this point we can adjust his dosage of medicines. Right now you have mentioned only about insulin. I would prefer to have my patients on metformin as well. This will make their body more responsive to insulin. I know what i am telling you now cannot happen overnight. But for a better and long term successful management these steps are essential. Hope i have answered your query Dr.Riyaz Sheriff