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What Causes Weakness, Tremors, Brain Fog And Loss Of Appetite In Diabetic Patient?
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
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!
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
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?
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!
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
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.
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!
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!
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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