Suggest remedy for sores on tongue in a diabetic person

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Posted on Wed, 10 Dec 2014 in Diabetes
Question: I am diabetic for last twenty years. For last two years I am suffering from sores on tongues due to constant interaction with teeth. Consulted ENT and dentist and have prescribed SM Fibro and Becosules. The sores get healed and come back again. I am on Amaryl 1 mg (morning) Jalra 50/850 ( 2times)and Atorsave 10 mg. Of lately I am facing constipation problems too. Everynow and then I have to do colon cleaning with Isabgul/castor oil and sometimes with 1/2 packet of phegelac too. But after cleaning again I face the problem. I do not feel I have emptied my bowel completely and stools are not hard. My gastro states that nerves near anus have become weak to respond for fecal movement. He advices to go for low dose of insulin. My fast sugar is 120-130 and PP 2 hours 200-230. HbA1c 8.2-8.5. Gastro adviced to take rabelet-d 2 times a day and Gutclear for constipation. I feel that my anus opening needs some activation for discharge. What is best remedy? I tried detergent few times but I know it is not advisable. What so do suggest for tongue sores/anus activation
doctor
Answered by Dr. Niranjan G 39 minutes later
Brief Answer:
The problems can be controlled.

Detailed Answer:
Dear sir,

You need to be very much dedicated and with a positive mind set to keep your problems under control.

First of all, you need to keep your sugar levels under control. Take insulin properly regularly ..
Take care of your nutrition try to add more of green leafy vegetables, oats which adds good amount of fibers to your gut and help you to relieve your constipation. Please do walk at least for half an hour to one hour a day. Take care of your oral hygiene and antibiotics to cure the problem.

In this situation your glucose levels should be strictly monitored with regular checks. You may need higher insulin doses at least till your infection is cured. Please meet some yoga specialists there are some asanas to relieve constipation.

Once your ENT problems are solved please check your HbA1c and lipid profile too. Take more of omega 3 fatty acid s.. Example fish, nuts especially walnuts more of green leaves which will provide you the necessary vitamins and minerals .. with proper dedication and self confidence you can lead a normal life. Divide your meals in to 4_5 small parts. Tab.Neurobion forte once a day after food For a month will help.

Please contact me if you have any other clarifications. IF YOU KEEP YOUR SUGAR LEVELS UNDER CONTROL ALL SUCH PROBLEMS CAN BE PREVENTED.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Niranjan G 46 hours later
Dear Sir,

I am afraid to state that you have not read my matter correctly. I am facing two major issues as follows;

1. Tongue Sores: The same appears on lateral sides due constant rubbing of tongue against the teeth. These sores appear as reddish patches surrounded by white border. Some doctors have identified as "Geographic Tongue". I am currently using SM Fibro - which has Lycopene, Betacarotene, Selenium, Zinc & Copper Sulphate, Alpha Lipoic Acis, Alpha Tocopheryl Acetate. I had been told these ingredients are there in greeny vegetables. However I am also having greeny vegetable also. Further, in addition to this I am having Becosules. In such scenario why is that my sores are not getting healed? Also apart from this I also use Hexadine mouthwash and apply gingely oil to my sores. Denstist have not been able to find the cause for this problem and I am not able to get relief from the same. Currently I am not able to eat hot and spicy foods. I have also grinded my tooth to avoid sharp tooth syndrome. How will I able to get relief from these sores?
2. My Sugar levels tested last week were: 121 & 221. Hbalc - 7.8. I am not under Insulin currently. Should I go for low dose of the same in addition to medicines as mentioned already?
3. Improper Bowel Movement: Earlier, I use to pass motion once in the morning and use to complete my bowel completely. For last four months, I get regular bouts of constipation for which I do colon cleaning with Isabgul/Castor oil. But after the it gets cleaned, I have the same problem persisting. I am not able to empty the bowel fully and have to visit restrooms few times in the morning but even then not able to pass any motion. Due to this I get abdominal pain every now and then. Due to this problem, I am not able to go for my regular walking also?
4. I am only 47 kgs. Hence if try to control my diet, I become very weak. In case if I have full diet my levels go up. Hence my levels fluctuate too much. Kindly let me know How to maintain the same. During 11 am, I have 4 almonds and walnuts. Does almond create constipation and do walnuts aggravate the sores? I cannot have fish as I am vegetarian
5. Since you have very long experience in diabetic field, I would like to know the best recourse for the above mentioned problems based on my history. Awaiting to hear from your side.
doctor
Answered by Dr. Niranjan G 46 minutes later
Brief Answer:
You are on the right medical care .. you will be alright soon.

Detailed Answer:
Dear sir,

I understand your problems... here are my suggestions for them in detail

1. your HbA1c levels are still high !!!.. I want it under 6.5 .. if the sugar levels are not under control the ulcers will not heal especially in mouth where we can find lots of bacteria even anaerobic .. it is unlikely that it is geographic tongue .. geographic tongue is due to riboflavin deficiency and you have been taking the nutritional supplements for a long time now.. I would recommend you to meet a good maxillo-facial surgeon..the ulcer could be due to constant irritation which is persisting and causing ulcer repeatedly!! the cause need is to be removed. you told you are using mouth wash that is good .. do it regularly.. apply DENTO GEL over the ulcer after rinsing your mouth in XXXXXXX warm water.. wash your mouth and brush every time you eat..

2. You need to increase the dose of the insulin no doubt ... till the ulcer heals .. some times when we have ulcer we need more insulin to bring down the glucose levels ..

3. you need to add more of fibers to your diet .. like green leafy vegetables, oats, fruits ... you need to try and exercise the abdominal pain might be non specific .. if it persists go for a routine ultrasound scan (if uncontrollable).. long time use of castor oil is not advisable please avoid. if you still feel that you are having constipation .. it is due your stress... irritable bowel syndrome .. there will not be any problem due to stress / nervousness you will feel you did not empty your bowel completely.. please add tab.equirex in the morning after breakfast for a month and see. please do meditate and practice pranayama definitely it take time but surely it will help you...

4. Almonds, walnuts, sprouts. millet's are very good for your health now you must consume they will not cause constipation .. in fact millets are rich in fibers they help you in relieving constipation...

5. you need to wait and have patience and follow the advice ... lifestyle changes are very very important ,,, in your case .. try to avoid stress.. the dental problem if it is not cured after controlling the the sugar and removal of irritant tooth... better go for a biopsy (but you will be alright soon)...

I hope I have given you sufficient advice based on the information I got from you ... please do contact your surgeon and treating physician soon... please do write me any time for questions .....

THANK YOU ,,, ALL THE BEST
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Answered by
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Dr. Niranjan G

Diabetologist

Practicing since :2003

Answered : 633 Questions

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