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Suggest Treatment For Weakness And Antisocial Behavior In A Diabetic

Posted on Thu, 22 Apr 2021

Question: Hello,

My Father is 63 years old and a Diabetic for last 2 years. He often complains of weakness, prefer to take rest and avoid any kind of physical activity. Also, he likes to stay at home and avoid socializing. He is taking regular medicines prescribed to him for diabetes.
Please suggest how to deal with weakness and possible remedy to make him social and outgoing.

Thanks, XXXXXXX

Answered by Dr. Saumya Mittal (4 hours later)

Brief Answer:
needs further information

Detailed Answer:
Hello XXXXXXX
I am Dr Mittal.
I have read your message.

The symptoms of your father are quite like Frontotemporal Dementia.
But to say that it is this disease, detailed information is needed.

I would like to know a little more about your father's symptoms.
Please tell me how long has he had these symptoms?
Are these symptoms slowly progressing?
Is there any other complaint- possible behavioral change?
Any memory loss?
Any food habits change?
Please cite these symptoms, if present, with examples.
I would like to know more about his weakness too.

Also, please inform me about all the medicines he takes, and the control of sugars.
I would surely try to help you.
But the above information is necessary to make a diagnosis.
Thereafter a possible treatment line can be suggested.

Awaiting your response, Dr Mittal

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Saumya Mittal (16 hours later)

Hello Dr Mittal.

Thanks a lot for your reply!

I will get back to you with details as required, shortly.

regards, XXXXXXX

Answered by Dr. Saumya Mittal (5 hours later)

Brief Answer:
Awaiting response

Detailed Answer:
hello again XXXXXXX
awaiting your detailed response.
thanks for your interest.
Dr Mittal

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Saumya Mittal (40 hours later)

Hello Dr Mittal,

Following is the detail as required:

My Father is 63 years old and a Diabetic for last 2 years. He often complains of weakness, prefer to take rest and avoid any kind of physical activity. Also, he likes to stay at home and avoid socializing. He is taking regular medicines prescribed to him for diabetes.

Symptoms: Weakness, not willing to walk, tastelessness (improved), Prefers to stay at home, not outgoing.

Please tell me how long has he had these symptoms: Last 1.5 - 2 years

Are these symptoms slowly progressing: Not really, he has shown signs of improvement, he often says I am ok and will improve. He wants to get well but cites weakness as a reason for not doing any physical activity and going out.

Is there any other complaint- possible behavioral change: Initially there was change in behavior, but it has improved overtime, he prefers talking when someone comes to visit him at home and remembers birthdays and important dates.

Any memory loss: Not really

Any food habits change: Changes in diet as suggested for controlling diabetes. Mostly vegetarian, sometime eats fish and egg,

I would like to know more about his weakness too: He doesn't feel energetic enough to venture outside, prefers to stay at home and perform all his routine work, likes to watch TV and takes rest.

Medicines taking: Ramipril (5 mg), Gleperimbe (2 mg), Poglotazone (15 mg), Esamaperozole.

Please suggest appropriate course of action.

Thanks, XXXXXXX

Answered by Dr. Saumya Mittal (2 hours later)

Brief Answer:
Suggestions

Detailed Answer:
Hello XXXXXXX
Thanks for your response.
I would have preferred a more elaborate answer- like I said please do mention examples say supposing for behavioral changes. Similarly with diet changes I wanted to know any change in diet from his end, not the ones recommended for diabetes.

Anyways, there are 2 possibilities I can think of in this situation-
1. as I said last time, a frontotemporal dementia.
2. depressive disorder.
Considering that you feel that he improves spontaneously sometimes, I think this latter is more probable.
But it needs a prolonged history and examination of his higher mental functions before the diagnoses can be finalized.

I would really recommend meeting neurologist/psychiatrist in your area for testing the higher mental functions.
As is obvious, the treatment would be very different in the 2 conditions.
In the case of depression, some antidepressants can be prescribed in a suitable dose.
In case of Frontotemporal dementia, there is no curative treatment, except suggestions can be made on how to make him more comfortable.

Finally, I would recommend testing Vitamin D levels and MRI Brain for him.
Please watch his sugars and Blood pressure- low BP and low sugars can both cause similar symptoms and can be reversible as and when the levels improve.

I hope this helps,
Best wishes, Dr Mittal

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng