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Taking insulin injections for brittle diabetes. Mouth is sore with yeast infection

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Practicing since : 2006
Answered : 1583 Questions
I have brittle diabetes. I am taking insulin injections three times per day. Humilin R 500 concentrate. 15U X 3 daily plus 2000mg X2 metformin, and 5mcg Byetta X2 daily. My legs are life blue road maps and the cardiologist has me wearing support stockings until they strip my veins in January. My teeth are terrible and my mouth is always sore. I'm under a dentists care and proceedures. I had to take ampicillin and ended up with one heck of a yeast infection. My primary care physicial ordered flucanazole, one per day X 3 days. One week later it's back with a fury. I'm misserable. Without being held accountable in any way, could you help me? For instance: Monostat 3, asking for another round of flucanazole? I am not having ANY sexual relations, nor have I had in three or four years. Help?
Posted Sun, 24 Nov 2013 in Diabetes
Answered by Dr. Basheer Ahamed 44 minutes later
Brief Answer: Brittle diabetes or Labile diabetes. Detailed Answer: Hello, Welcome to XXXXXXX Thanks for your query. Brittle diabetes is a form of type I diabetes which is hard to control. So you will experience extreme swing in the blood sugar value, hyperglycemia and hypoglycemia. So this uncontrolled status of diabetes is making your prone to bacterial and fungal infection due to immunosupression.(Definitive phagocytosis) Brittle diabetes may be due to definitive absorption of insulin, drug interaction and delayed gastric emptying. Psychological issues like stress and depression. It also creates adrenal and thyroid problems which you are already suffering from. In my patients I will treat both the physical and psychological cause to effectively manage brittle diabetes. I will advise my patients to regularly track the blood sugar to able to tract the glucose instability. Behavioral, psychological and environmental causes should be addressed adequately. In my opinion another round of fluconazole may be give to treat the present fungal infection and followed by a prophylactic dose of 150 mg of fluconazole may be given once a week to prevent the future oral fungal infection. Hope the answer helps you. Let me know if there are any further clarifications. Regards.
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Follow-up: Taking insulin injections for brittle diabetes. Mouth is sore with yeast infection 1 hour later
I am type II. Does this make a difference in your diagnosis? I am in so much discomfort.
Answered by Dr. Basheer Ahamed 4 hours later
Brief Answer: No difference in the diagnosis. Detailed Answer: Hello, Brittle diabetes is mostly encountered in type I diabetes. It can be a problem in a small fraction of type II diabaets. This will not make any difference in the diagnosis of brittle diabetes. I advise would be, try to control the blood sugar to near normal levels. Effectively control hypothyroidism with optimum dose of thyroxin. Learn relaxation techniques and try to lead a stress free life. Regards.
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