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diabetic foot care

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?

Asked On : Wed, 7 Jul 2010
Answers:  2 Views:  505
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Diseases and Conditions
Diabetologist 's  Response
Hba1c is 9. That means her sugars are shooting up even on the current treatment. Insulin dose must be titrated after monitoring sugars 5 times a day by glucometer.

Chances are, there is abnormal pressure on the ulcer site while walking. Change of footware (preferably diabetic footware) after consultation of a foot surgeon is advised. This is called offloading. Until the load is lifted off the ulcer, it won't heal. Worst case scenario - if the blood vessels are involved, there is a slim chances of the ulcer getting healed very rapidly.

Ideally I'd like her to have a visit to an institute dedicated to diabetes where she could be evaluated by foot surgeon and a diabetologist, both.
Answered: Tue, 26 Apr 2011
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General & Family Physician Dr. Khaleel Ahmed.Manik's  Response
broad spectrum antibiotics , daily dressing well control of blood suger will diefinitely improve her ulcers.
Answered: Tue, 26 Apr 2011
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