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Have diabetes, painful toes. On long term insulin, marijuana. Help?

I was diagnosed with type 2 diabetes 3 years ago. Most of that time my diabetes has been uncontrolled, with blood sugar levels 200 + fasting and 300+ following meals. I currently take a fast-acting insulin and long-term insulin. When I take my insulin consistently, which has been hard to do, my fasting level is 80 and post-meal is 110. I am a 42 year-old male who smokes, drinks, and legally uses "medical marijuana." I eat healthy meals at least 50 percent of the time. My real question, is I am having sharp, intermittent pain on my big toes. I have had that pain for about 8 months. Lately, the pain had extended to my big toenail. DO YOU THINK THIS IS SIMPLY GOUT, or could it be a complication of my diabetes?
Asked On : Sat, 13 Apr 2013
Answers:  4 Views:  48
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General & Family Physician 's  Response
Sep 2013
Hello, Thanks for the query.
I am sorry to say that you are doing each & every thing which increases your disease.
Either you are taking disease as very simple or ignorant knowingly.
Please note down that this is the one of worst disease in the world. Don't take it lightly, be serious.
The pain which you are feeling in your toenail is an indication diabetic neuropathy , if not treated in time may be serious for you.
If your's diabetes responding to INSULIN , this is the best thing for you .
Pain in your big toe is not due to gout etc but due to diabetes.
So please take proper dose of insulin and remain healthy. Good luck . Dr. HET.
Answered: Sat, 13 Apr 2013
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General & Family Physician Dr. Pavan Kumar Gupta's  Response
The reason for pain in your big toes could be gout as well as peripheral neuropathy due to uncontrolled diabetes.
While gout and diabetes seem unrelated at first glance,there is  strong interconnection between them.In patients with type II diabetes, uric acid levels in the blood can rise. Because diabetes contributes to poor circulation, the uric acid can build up in the extremities and gravitate to the joints, causing gout. Having diabetes can cause gout if the diabetes is poorly controlled.

Similarly this pain could be due to peripheral neuropathy due to uncontrolled diabetes.
The main risk factor for diabetic neuropathy is hyperglycemia.  The progression of neuropathy is dependent on the degree of glycemic control in diabetes. Duration of diabetes, age, cigarette smoking, hypertension, and hyperlipidemia are also risk factors for diabetic neuropathy.

You are playing with fire by not being serious towards maintaing your blood sugar levels.
Diabetes is a multi organ disease and has affect on all the organs of body.
You must consult your doctor and get the proper investigations done and take appropriate treatment.
Take your insulin regularly.
Keep your sugar levels in tight control.
Observe dietary restriction and shed weight.
Quit smoking and marijuana and may take alcohol in very moderation.
Regular aerobic exercises.
Control your blood pressure and your lipid levels.
Take appropriate medicines for your peripheral neuropathy.
Remember uncontrolled diabetes leads to various future micro as well as macro vascular complications in future.
Answered: Sat, 13 Apr 2013
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Internal Medicine Specialist Dr. Akhilesh Dubey's  Response
Welcome to HCM,
You are having Diabetes type II you must understand this is lifestyle disease and you need to take care of diet 25 Kcal kg body weight balanced diet avoiding refined sugars.
If you are taking Insulin please take it regularly to keep your blood sugar in desirable range to prevent short term and long term diabetic complications.
Please check your FBS,PPBS,HbA1c,Uric acid level and Lipid profile after consulting your Physician.
It is common to have gouty arthritis in great Toes.You can do X ray to check type of arthritis.
It is possible to have peripheral neuropathy which can occur in diabetic usually it produces numbness and tingling.
Please take care of your life please quit smoking and drinking alcohol also stop taking marijuana.
Take care of diet.
If it is gout it can be treated with prescription drugs.
Please take care
Good Luck
Answered: Sat, 13 Apr 2013
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

You have not stated your age, gender, personal habits, family history or co-morbidities
Peripheral neuropathy is the prime possibility...
Next in line is peripheral vascular disease / Gout of course has a place in distant the list

Diabetes is a serious disease and is considered equivalent to Heart disease
Help yourself by cutting off preventable additional risk factors like Smoking, Drinking and marijuana and so on... Counselling can help

Take care
Wishing speedy recovery
God bless
Good luck
Answered: Fri, 19 Apr 2013
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