Sugar... sweet yet deadly?
An elderly couple came in yesterday looking extremely anxious and sad. The husband, about 60 years old virtually hobbled in and sat unsteadily on the chair. Looking frail with that greyish tint around his face, he complained of general body weakness as well as pain and numbness in both his legs and hands. Both legs appeared,skinny ,dry, darkish and marked with multiple ulcers in various stages of healing.
Old record showed that he had been diagnosed as suffering from diabetes for some years back but had defaulted regular follow up. To make matters worse, he was also a heavy smoker. He misplaced/lost his diabetes card on several occasions and when asked why he did not come for his regular review, the wife quickly answered that they had been busy. She spoke too fast with her eyes looking everywhere except at me.
On examination, it was noted that he had lost sensation on his feet and hands. His pulses (dorsalis pedis) on both feet were absent. His feet felt cold due to lack of blood coursing through. In short, he is sufffering from two of the complications of uncontrolled diabetes, that is, blocked small blood vessels and damaged peripheral nerves supplying his feet and hands to some extent. Under these circumstances, tissue death and gangrene will gradually set in and amputation of affected legs is inevitable.
Medical jargon refers to small blood vessel damage as vasculopathy and peripheral nerve damage as neuropathy and his blurring of vision due to damage to blood vessels to the retina is known as retinopathy. And most likely his kidneys are also damaged by the same process and this condition is known as nephropathy, a condition preceding kidney failure.
It happened that the wife was an agent of a direct selling product which claimed that it could cure diabetes and the husband had been taking the product for some time. In fact the wife had previously been promoting her products to some of our patients by claiming that the husband had then been cured of diabetes since using the product and no longer had any need of doctor's medicine and monitoring! Now those patients were mocking her.
His blood and urine tests showed up excessive sugar and the wife whispered that her husband's urine smelled like "animal's urine".... and could anything be done to save his legs?..... What could I say ?
An elderly couple came in yesterday looking extremely anxious and sad. The husband, about 60 years old virtually hobbled in and sat unsteadily on the chair. Looking frail with that greyish tint around his face, he complained of general body weakness as well as pain and numbness in both his legs and hands. Both legs appeared,skinny ,dry, darkish and marked with multiple ulcers in various stages of healing.
Old record showed that he had been diagnosed as suffering from diabetes for some years back but had defaulted regular follow up. To make matters worse, he was also a heavy smoker. He misplaced/lost his diabetes card on several occasions and when asked why he did not come for his regular review, the wife quickly answered that they had been busy. She spoke too fast with her eyes looking everywhere except at me.
On examination, it was noted that he had lost sensation on his feet and hands. His pulses (dorsalis pedis) on both feet were absent. His feet felt cold due to lack of blood coursing through. In short, he is sufffering from two of the complications of uncontrolled diabetes, that is, blocked small blood vessels and damaged peripheral nerves supplying his feet and hands to some extent. Under these circumstances, tissue death and gangrene will gradually set in and amputation of affected legs is inevitable.
Medical jargon refers to small blood vessel damage as vasculopathy and peripheral nerve damage as neuropathy and his blurring of vision due to damage to blood vessels to the retina is known as retinopathy. And most likely his kidneys are also damaged by the same process and this condition is known as nephropathy, a condition preceding kidney failure.
It happened that the wife was an agent of a direct selling product which claimed that it could cure diabetes and the husband had been taking the product for some time. In fact the wife had previously been promoting her products to some of our patients by claiming that the husband had then been cured of diabetes since using the product and no longer had any need of doctor's medicine and monitoring! Now those patients were mocking her.
His blood and urine tests showed up excessive sugar and the wife whispered that her husband's urine smelled like "animal's urine".... and could anything be done to save his legs?..... What could I say ?
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