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Suggest treatment for elevated blood sugar levels

Answered by
Dr. Abhay A Mali


Practicing since :2006

Answered : 805 Questions

Posted on Fri, 3 Mar 2017 in Diabetes
Question: Hi,

My mother is suffering from Diabetes (Type 2) since last 15 years.
Age 59yr.

Blood sugar level keeps slight elevated normally - about 150-170 if we take average, despite of taking medicines.

Since last about 15 days, there are some swelling and pain in foot (ankle area). This is now in both foots and both foots are swelled and painful and these have slight red in color. The swelling in one foot has slight blackish appearance too.

Please advise,
1. What may have gone wrong.
2. What care we need to take on urgent basis to prevent further damage.
3. Which specialist to consult.
4. What lifestyle changes is required.
5. Any eating/ food care to be taken.
6. Do we need to consult to any multi-specialty hospital (like Manipal etc) or normal family doctor is sufficient to take care of it.
7. Any other input from your side, which is to be taken care of.
Answered by Dr. Abhay A Mali 55 minutes later
Brief Answer:
Need immediate physical examination by foot surgeon.

Detailed Answer:

Thanks for your question.
Noted your concern.

Swelling with redness denote possibility of cellulitis (infection of soft tissue of foot).
Blackish discoloration denote possibility of compromised blood supply to foot.

I may suggest to go to ER immediately.
There is a need for -
1) Detailed physical examination of foot for type of injury, assessment of blood supply, neuropathy changes.
2) Depending upon physical examination there may be need for following evaluation
- Complete Blood Count.
- HbA1c.
- Renal Function Test including Serum Uric acid.
- Liver Function Test.
- Arterial blood gas assessment.
- Urine examination.
- Xray of foot.
- Ultrasound with Arterial doppler of both legs.

Depending upon all above there may be need for hospitalization and surgical intervention.

One by one answer to your questions
1) It is called as diabetic foot.
Diabetic patients are prone to develop foot problems due to
- Increased chances of infection.
- Diabetic neuropathy.
- Diabetes vasculopathy (lack of blood supply).
2) Urgent physical examination by experts is required without any further delay.
3) Consult diabetic foot specialist or at least general surgeon.
4) 5) Off loading of diabetic foot is usually suggested but in your mother's case lifestyle modification & diet modification may not alter course of acute emergency.
6) There is a need for combined efforts of diabetologist, diabetic foot surgeon, Dietitian & physiotherapist. So better to go to Multispeciality Hospital.

Hope this helps.
Without delay go to ER where primary evaluation can be done.

Dr Abhay Mali.
Above answer was peer-reviewed by : Dr. Prasad

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