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Hi I Am 71 Yo. Have T2DM But A1c Has

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Posted on Tue, 18 Dec 2018
Question: Hi I am 71 yo. Have T2DM but A1c has been in control fro years. Treated w Metforman and nothing else for 30 yrs. I am obese. Other prob are HTN,GERD, AFIB, and elevated cholesteral but all are well controlled w meds. Last January I began having prob w pain in the top of my R foot, fatigue, and a change in balance. The pain has gotten progressively worse and both feet are involved. No one has been able to dx me. I am currently on Lyrica 75mg daily and Cymbalta 120mg qd w no change. I am also a retired nurse practitioner. Thanks for any insight to this.
doctor
Answered by Dr. Dr.Dorina Gurabardhi (53 minutes later)
Brief Answer:
Probably peripheral neuropathy due to diabetes.

Detailed Answer:
Hello dear and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

Your symptoms seem to be related to peripheral neuropathy due to diabetes.

This is a complication of diabetes caused by nerve damage.

To confirm the diagnosis I suggest the following examinations :

a complete blood count

glycemic level

Electromyography which can help in detecting nerve damage.

CT or MRI

Meanwhile, the most important thing is to maintain blood sugar levels under control.

For the pain I would recommend taking anti-inflammatory medication such as Ibuprofen 400 mg three times a day.

I also recommend to continue using Lyrica as a preferred medication to treat neuropathy.

You can also try local treatment such as Capsaicin cream for local application.

Regular physical activity is also needed to help with the pain.

If the symptoms continue a neurological examination is needed.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr.Dorina Gurabardhi (1 hour later)
Thank you. That’s what I have been thinking also.
doctor
Answered by Dr. Dr.Dorina Gurabardhi (5 hours later)
Brief Answer:
You are welcome.

Detailed Answer:
Hi again dear,

I am glad I could help you.

You are welcome for any other queries in the future.

Wishing you a good health.

Take care,

Dr.Dorina Gurabardhi
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Dr.Dorina Gurabardhi

General & Family Physician

Practicing since :2013

Answered : 13592 Questions

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Hi I Am 71 Yo. Have T2DM But A1c Has

Brief Answer: Probably peripheral neuropathy due to diabetes. Detailed Answer: Hello dear and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Your symptoms seem to be related to peripheral neuropathy due to diabetes. This is a complication of diabetes caused by nerve damage. To confirm the diagnosis I suggest the following examinations : a complete blood count glycemic level Electromyography which can help in detecting nerve damage. CT or MRI Meanwhile, the most important thing is to maintain blood sugar levels under control. For the pain I would recommend taking anti-inflammatory medication such as Ibuprofen 400 mg three times a day. I also recommend to continue using Lyrica as a preferred medication to treat neuropathy. You can also try local treatment such as Capsaicin cream for local application. Regular physical activity is also needed to help with the pain. If the symptoms continue a neurological examination is needed. Hope I have answered your query. Let me know if I can assist you further.