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Diabetes, high BP. On diapride. Why does she have dizziness? - Online Doctor Chats

Date : 30-May-2013
User rating for this question
Very Good Posted in: Diabetes
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
Doctor:How can I help you?
Doctor:How are you?
User:need your opinion regarding my mother. 66 years old
Doctor:I shall help you with your concern.
User:diabetic and high BP for past 18 years
Doctor:Proceed with your query.
User:undergoing following medications:
User:1. Diapride Forte 1-0-1 and 2) envass 10 mg 1-0-0
User:she is feeling dizzy on and off
User:would you relate it to diabeties and sugar levels
Doctor:Yes, dizziness may be related to diabetes and blood pressure.
User:she has a glucometer and fasting sugar for past week is in the range of 150 to 170
User:blood pressure is usally in the range of normal
Doctor:I would be able to understand the problem better and give you better suggestions if you can answer few of my questions relevant in this context.
User:sure doctor
Doctor:Since how long has she been having diabetes and blood pressure?
User:18 years
Doctor:Have you been following up with her doctors regularly?
Doctor:When was the last blood test done?
User:mid of dec
User:a test to see the trend of blood sugar level of past 3 months
Doctor:Since when is she having these dizzy episodes?
User:2 weeks
Doctor:For how long does she have this dizziness and approximately how many episodes in a day?
User:1 to 2 episodes a day almost everyday and she feels very discomfortable after the episode
User:this started about 2 weeks back
Doctor:Is there any factor that precipitates the attacks
Doctor:such as change in the posture,
Doctor:from sitting to standing posture?
User:just a sec doc.. i ask her
User:it happens while walking or while lying sleeping
Doctor:Is she running fever?
Doctor:Does she have any problem with hearing?
Doctor:Does she complain of imbalance / Is she able to walk properly?
User:yes she walks propoerly
Doctor:Does she have nausea or vomiting sensation?
User:vomitting sensation comes along with dizziness
Doctor:Does she have any heart problems?
Doctor:Let me brief you.
User:doctor 1 more thing
User:as you asked about imbalance,she does not have control over her steppings for a fraction of sec when the dizziness happens
Doctor:That clarifies few things.
Doctor:I shall brief you now.
User:sure doctor
Doctor:Dizziness is caused by multiple conditions related to ear, brain and heart.
Doctor:In the background of long standing (8 years) diabetes and high blood pressure, there is a possibility
Doctor:that she may be having autonomic disturbances.
Doctor:Autonomic disturbance would cause postural hypotension.
Doctor:In simple words, anyone who has long standing diabetes and high blood pressure
Doctor:can be subjected to blood pressure fluctuations.
Doctor:And these fluctuations usually happen with change of posture such as when some one stands suddenly from sitting or lying down posture.
Doctor:You can confirm with your mother if she feels dizzy and feels like falling when she stands suddenly from sitting or lying down posture.
Doctor:If yes, then you can get her blood pressure recorded at her doctors office in lying down, sitting and standing posture.
Doctor:This will confirm this possibility.
Doctor:Are you following?
User:no the pattern usually is not while changing the postures
User:but comes suddenly while walking or lying down
Doctor:If there is no relation with change in posture, then it might not be postural hypotension.
User:can record the BP in all the 3 postures though to see if there is variation
Doctor:Yes, you can do that and confirm it.
Doctor:If postural hypotension is ruled out,
Doctor:then the next common cause is benign vertigo
Doctor:A condition which is related to some minor disturbance with ear.
Doctor:The third possibility is metabolic disturbances - low sodium levels
Doctor:which is associated with blood pressure medications.
Doctor:The following are my advise to you
User:Na level were normal in december
Doctor:1. You would need to report to her physician for physical examination and some relevant tests
Doctor:2. She would need her blood pressures checked as described earlier.
User:sure doctor
Doctor:3. Few relevant investigations such as blood sugars, repeat serum sodium levels, other metabolic work up and ECG may be needed.
Doctor:4. If all the test are normal, then your doctor can
Doctor:prescribe her anti vertigo medication such as vertin or stemetil
Doctor:These medications taken for 2-4 weeks will solve her problems.
User:sure doctor
Doctor:5. In the meantime as you make arrangements to consult your doctor,
User:yes i will
Doctor:make sure your mother does not go alone to places such as higher than ground levels, does not get up abruptly.
Doctor:I don't think we are dealing with a serious problem but proper blood sugar and blood pressure maintenance is essential.
Doctor:Have you followed ?
Doctor:Is there any other query?
User:yes doctor ..
User:2 queries
User:1. you said higher than ground level..she stays on 14th floor..can that be related
User:2.for the benign vertigo does she require some ear investigations
Doctor:I suggested her not to go to higher level alone to avoid any falls following dizziness.
Doctor:Staying at a higher level is not related to the dizziness.
User:yes that we are taking care
User:we do not let her go alone for walks these days
Doctor:2. Benign vertigo is usually related to minor ear disturbances.
Doctor:If an ear examination reveals any pathology, she may be advised to get some relevant test such as audiometry.
Doctor:I would encourage you to consult her physician.
User:sure doctor..
User:since she is at our home town,i thought of taking your opinion
Doctor:Her doctor will streamline the tests.
User:will make arrangements to see the physician
User:thank you much
Doctor:You are welcome.
Doctor:Thanks for consulting me.
Doctor:Bye for now.
User:thank you .bye
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