Appearance
question:I have some discoloration in my lower legs which has gotten better since raising my feet on pillows when sleeping.. Also had eyes checked as sometimes when driving, I see the lines on the road as wiggley or doubled. Closing one eye fixes that. Optometrist thought I may have had a small stoke in one eye. Opthomalagist said possibly due to lack of sleep. Noticed that my left eye lid is drooping so I can see it like a poor fitting contact in that eye. My diabetes numbers are good and my Diabetes Dr said I m under 6.0 and I don t have neuropathy. Should I be concerned or continue on as is. Oh- my left leg where it s discoloered, the skin is sensitive
answer:Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.If your diabetes is well controlled with an HbA1c% as regards the discoloration observed in feet, it could be due to swelling of the feet, which may be due to dependent edema. Please check your blood pressure and also kidney functions. Since there is no mention of your weight and height, being overweight can also lead to such a problem. If BP is high, get it properly controlled. Also, get the blood supply to your lower limbs as in diabetes blood vessels of lower limb are affected. A color Doppler study will help.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Prabhakar Laxman Jathar
question:I am a 64 year old diabetic who has developed symptoms recently that I am concerned about. I have a constant pain of different strength under the lowest rib on my right side. It eases when no belch, pass gas, or evacuate my bowel. Yet I never feel like me bowel is ever totally empty, and have some distension in my abdomen. I am frequently warn out in spite of sleeping well. I take inseparable for acid reflux as well as a probiotic.
answer:Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.The pain in the abdomen you have relieved by belching and passing stools is most probably due to gastritis only. But, if it is for quite a long time, you should at least do one USG abdomen followed by an endoscopy if required later. Sometimes, few antidiabetic drugs also cause a feeling of fullness and bloating in abdomen but you have not mentioned which medicines are you on. Also, sometimes other coexistent disorders like thyroid will cause wearing off sleep and also bowel disturbances. So, please get a thyroid profile also done. For now, please continue the antacids, avoid spicy and junk food, exercise regularly and do the tests as advised.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Vineeta Singh
question:Hello. My name is Angela. My boyfriend is 25 years old. He has recently been diagnosed with type 1 diabetes, about 5 months ago. Lately, he has been having slight chest pain, no energy at all, and dizzy spells very often. His current doctor said it is because his body is still adjusting to the insulin....but does it really take the body this long to adjust to insulin? I don t think he should be having chest pain and dizzy spells. He says he feels weird . His current doctor is booked until July. We are thinking of going to emergency room, but I would like an answer from here first. His doctor also said he is in the honeymoon stage of diabetes. I believe he has not been monitored by his doctor closely enough.
answer:Hello and Welcome to ‘Ask A Doctor’ service.I have reviewed your query and here is my advice.Following are my observations and suggestions: 1) Chest pain is unlikely to be there due to the body getting adjusted to insulin because the effect of insulin is to reduce excess blood glucose and normalize the levels. 2) Chest pain could be because of overall weakness and fatigue which does happen in uncontrolled diabetes. 3) Honeymoon phase is a condition that occurs in T1 DM when insulin injections are given, the remaining pancreatic beta cells (which are insulin producing) get rest as there is no load on them. This improves their function and they start producing more amount of insulin. Thus the requirement of exogenous insulin reduces. Plus patient shows a better blood glucose control. This phase may last for a few weeks to months or longer. But invariably for few weeks. 4) If the patient is feeling tired and exhausted, that means his blood glucose is not well controlled. If glucose levels are well controlled then general health of the patient rapidly improves. It is necessary to monitor insulin dosage, dietary intake, and blood glucose levels more closely and meticulously then only all the symptoms will be well controlled.Hope I have answered your query. Let me know if I can assist you further.Regards,Dr. Prabhakar Laxman Jathar
question:My friend just was in the hospital for a staph infection , did surgery. After he came home he was diagnosed with Diabetes. They did not do a fasting blood sugar. He has night sweats/chills. He can't sleep more than an hour at a time. His pulse rate is high. They put him on Glucophage, that makes his very sleepy. I think something else is going on.
answer:Hello, Thanks for the query.For diagnosing diabetes either fasting or PP blood glucose alone can be sufficient. Now a days mostly diagnosis is done on HbA1c%. If HbA1c% is>6.5%, diabetes is confirmed. Metformin is the firstchoise drug in T2 DM. Plus that drug does not cause drowsiness. Since this patient had already a svere Staph infection, it is possible that the same has not been cured completely. That is the reason for getting chills and fever. So please ensure that his infection is cured completely with appropriate antibiotics and also blood glucose level is also controlled properly. Ideally well controlled diabetic patient should have FBG <100 mg, PP 150 to 160 mg & HbA1c% <6.8. So only metformin may not sufficient. Thanks.
question:I am a 64 year old man with type 2 diabetes, sleep apnea, and asthma. Apnea is controlled with use of a CPAP. Asthma is controlled with Advair. Diabetes is not controlled, although I am taking metformin and byetta for it. I am about 50 lbs overweight. I also have erectile dysfunction. I have several high stress jobs including practicing law, professional music, and personnel management for a symphony. I am recently having moderate sharp stabbing pain that lasts less than one second in my right temple. These recur. I have timed them and the frequency ranges from 4 to 25 second intervals. This has been going on for about a week. Ibuprofen helps sometimes, but not always. the only trigger I have noticed is that sometimes when I turn my head quickly to the right, as in driving, this triggers it, but not always. They become less noticeable when I am fully engaged, for example in a music performance or a court hearing.I am also experiencing unusual fatigue. Sometimes routine tasks are very hard to do. I have also experienced loss of balance generally over the last few years. Also loss of strength. For example until a few years ago I routinely did 40-60 pushups per day, now I struggle to do 2 or 3. Lately I feel as if I am sometimes confused and disoriented. My cognitive functions feel impaired. Routine tasks like driving, and playing my instrument are normal.
answer:Hello, Thanks for the query.I have gone through the details given and I do understand yur concern. I have following few suggestions: 1) You will have to give a re-look at your diabetes treatment. Because if blood glucose is not well controlled then excess loss of glucose through urine (glycosuria) does lead to loss of energy and tiredness and constant fatigue. 2) Present treatment looks to be inadequate, some additional drugs need to be added. (since no blood levels or HbA1c% is mentioned, it is difficult to be specific). 3) Weight reduction is also very important as excess weight (fat) is the main cause for Insulin resistance. EVen a 5% reduction in present weight can help in improving blood glucose control. 3) Take a diet that helps better blood glucose control, avoid junk foods, high fat food products, increase intake of green leafy vegetables and salads, yogurt and low fat cheese. 4) Increase your time spent on exercise to abut 1 hour or more per day 5) Get a thyroid function test done, to rule out if there is hypothyroidism . 6) Lastly learn some relaxing techniques like Silva Mind Control Methods an alpha level relaxation which wiil definitely help in managing stress. Even ED which is a major long term complication of uncontrolled diabetes can be helped with better blood glucose control. Plus some medications also may be needed.I hope I have addressed some of your concerns. Thanks
question:Low energy, which is variable, joint aches, particularly knees and ankles, vision often blurs and becomes tunnelled during bouts of low energy, trouble concentrating in these periods, blood test show borderline type 2 diabetes with a family history. Had flu about 6 weeks ago, never really recovered.
answer:Hello, Thanks for the query.If you have diabetes then it is necessary to control the excess glucose level, then only you will feel energetic. If FBG is 108 to 125 mg, PP 141 to 199 mg and HbA1c% is But if you already have FBG 126 mg and above, PP 200 mg and above as well as HbA1c% 6.5 and above, then diabetes is confirmed. In such a situation excess glucose lost through urine causes loss of energy and tiredness and feeling low in energy. Since you have not mentioned any relevant details it is difficult comment very specifically. Even the attack of flu also adds to the weakness as it takes a bit longer to recover full normalcy after an attack of flu. So my advise is if you have diabetes then start the treatment straight away. Once blood glucose is well controlled, you will better. Thanks.