• question-icon

    What causes weakness, tremors, brain fog and loss of appetite in diabetic patient?

default
Posted on Fri, 3 Jun 2016 in General Health
Question: Hi My wife is 67 years old type 2 diabetic but in overall good health. she exercises daily. 6 days ago she started feeling weak jittery and shaky, brain fog,erradic sleep, she has not had much of an appetite for a few weeks and has lost 10lbs. She saw her doctor on thur. They drew blood and a chest xray, everything was fine, no thyroid issues blood tests were normal. they prescribed Prozac, possible depression. she has been on it 4 days no change in her condition This all came on so suddenly. Any thoughts on what could be going on would be very much appreciated. thank you
doctor
Answered by Dr. Panagiotis Zografakis 43 minutes later
Brief Answer:
hyperosmosis, thyroid disease, depression, stroke, worsening dementia

Detailed Answer:
Hello,

for a type 2 diabetic patient of her age the symptoms would raise suspicion for hyperosmolar non-ketotic hyperglycemia, that is a prolonged high level of blood sugar which caused dehydration.

Other potential common causes include thyroid disease, stroke, worsening of dementia and depression. Less common causes may apply but their incidence is much lower (encephalitis for example).

Since she's done various tests (you haven't mentioned which but I suppose that her doctor has done all the necessary tests) and everything was OK, the first couple of diagnoses can be excluded. If she had no neurologic deficit during clinical examination then stroke can also be excluded. You haven't mentioned any history of dementia. If she has dementia then it is possible that she's having a temporary (usually) worsening of her condition. The cause of worsening could be something so simple as a urinary tract infection, a bad tooth, changing environment, fever, etc

Depression is usually a diagnosis we reach after excluded organic causes. If no other disorder may explain her condition then depression could be the diagnosis. Prozac and similar drugs require much more time to show any benefit (at least 15-30 days).

I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Panagiotis Zografakis 31 minutes later
Thank you for your reply Dr Zografakis. Gloria's blood sugar levels are well within the parameders her doctor has recommened for quite some time. and she has never had any issues with dementia. After the blood tests and chest xray her doctor ruled out a thyroid issue. So it sounds like we just need to give some time for the Prozac to work for her?
doctor
Answered by Dr. Panagiotis Zografakis 22 minutes later
Brief Answer:
yes, probably...

Detailed Answer:
You're welcome!

If all the tests were fine (thyroid, hematocrit, urea, creatinine, electrolytes, etc) and her doctor cannot find clues to any organic disease then depression has to be treated. Prozac definitely needs more time.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Panagiotis Zografakis 30 hours later
FYI I Drove XXXXXXX to the hospital this afternoon, she was worse than yesterday. After insisting they redo her tests. they found her to be critically deficient with magnesium. ' .03. She was hospitalized and is doing much better.
doctor
Answered by Dr. Panagiotis Zografakis 25 minutes later
Brief Answer:
Glad to know she's better

Detailed Answer:
That's interesting! Didn't they check the electrolytes in the first visit?
Magnesium deficiency is not a common disorder in patients without uncontrolled conditions or certain drugs like the diuretics. Starvation may cause it. Certain renal problems may do so too.

It's easy to correct with supplementation. The underlying cause has to be investigated.

Best wishes for a speedy recovery!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3694 Questions

premium_optimized

The User accepted the expert's answer

Share on

Recent questions on  Thyroid disease

doctor1 MD

HI,i suffering from so many diseases from last 2-3 years..Sacroid,,then TB,,then thyroid ..TB course is done..for Sarcoid having steroids and 50 mg...

doctor1 MD

HI I M 23 YEARS YOUNG....MY ESR WESTERGREN VALUE IS 44, I HAVE ECZEMA (OF A ONE RUPEE COIN SIZE)IN LEFT FOOT SINCE 15 YEARS.... ALSO SINCE OCT.2011...

doctor1 MD

I am on thyroxine and have had my thyroid gland killed. My T4 levels are in the normal range 1.5) but my TSH is low (0.16). The doctor wants to...

doctor1 MD

Hello, I would like to know if an endocrinologist would be able to help my daughter. She is 18 years old. She has had headaches, constipation, and...

doctor1 MD

Hi. A few days ago I started experiencing heart palpitations. I feel my heart fluttering in my chest and throat. It doesn't happen when I am moving...

doctor1 MD

I recently got AMA - Anti Microsomal Antibody test done. The range was supposed to be 34 as Positive. My reading showed a Value of 91. The lab...

doctor1 MD

Thank you. About three weeks ago, I noticed a slight redness of skin at throat area. It waned and is now back on all over the front of my neck. The...

Get personalised answers from verified doctor in minutes across 80+ specialties

177 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Questions Answered By Dr. Panagiotis Zografakis
  • Q - Suggest treatment for splenic cyst

  • Q - What causes dry throat?

  • Q - What causes itching in breast?

  • Q - What causes chest pain and heart burn?

  • Q - Suggest treatment for pain in heels

  • Q - Can i take Paxil along with Clonidine?

  • Q - Suggest ways to manage diabetes

  • Q - Does taking Plaquinel for lupus affect the memory?

  • Q - What does an enlarged lymph node on neck indicate?

  • Q - Is infection possible by touching a dead bird despite using a disinfectant?

backtotop2