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Suggest Treatment For Bilateral Toe Ulcers While Having Diabetes
49yrs old female, type2 diabetes for 7 yrs, bilateral great toe ulcers, non healing for last 1 year, HbA1c-9% , VPT and HCP-grossly impaired, ABI:right-1.01, left-0.92 1. what other information do you require from this patient? 2. what is the primary goal of treatment for her? 3. do you think her diabetes control is adequate , and if not what might you suggest? 4. what teaching would you do with this patient? 5. what are the plans regarding treatment of her ulcers?
Mon, 15 Sep 2014
Dear sir i can understand your concerns
in my opinion this patient might be suffering with severe diabetic neuropathy.
diabetes is poorly controlled
as per her ABI report the blood supply is good.
further assessment is to go for foot pressure analysis to check for magnitude of pressure points and to plan offloading also and i would like to know BMI of patient also.
first and most important thing need to be addressed is diabetes control by adjusting medication with or without insulin.
the best plan for her is to consider meeting a podiatrist and use forefoot off loading footwear or rocker bottom foot ware which helps in reducing the pressure and heal wound.
regards
in my opinion this patient might be suffering with severe diabetic neuropathy.
diabetes is poorly controlled
as per her ABI report the blood supply is good.
further assessment is to go for foot pressure analysis to check for magnitude of pressure points and to plan offloading also and i would like to know BMI of patient also.
first and most important thing need to be addressed is diabetes control by adjusting medication with or without insulin.
the best plan for her is to consider meeting a podiatrist and use forefoot off loading footwear or rocker bottom foot ware which helps in reducing the pressure and heal wound.
regards
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1.creatinine=?
2.Primary goals: sugar control , infection control
3.not controlled, she is suggested insulin treatment with other oral agents(metformin to be avoided for risk of acidosis)
4.blood sugar checking(different times) ; regular follow up with both diabetologist and surgeons
5.Antibiotics, regular dressing , sugar control, avoid tobacco, customised footwear .
2.Primary goals: sugar control , infection control
3.not controlled, she is suggested insulin treatment with other oral agents(metformin to be avoided for risk of acidosis)
4.blood sugar checking(different times) ; regular follow up with both diabetologist and surgeons
5.Antibiotics, regular dressing , sugar control, avoid tobacco, customised footwear .
I find this answer helpful
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