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Is My Mother's Condition Shows That She Has Progressed To Type 2 Diabetes?
Question: My mother has experienced increased blood sugar level. The blood test result a few months ago showed Fasting Glucose of 6.6mmol/l, and HbA1C 6.8. For the past few months, her daily home monitoring showed 8-12mmol/l a couple of hours after meal. She previously took 1 tablet per day of the 500mg Metformin, and recently changed to 2.5tablet a day. The frequency of >10mmol/L has reduced but still every 3 or 4 days and regularly at 7-9mmol/L.
First question is - is my mother's condition shows that she has progressed to Type 2 Diabetes? does she need to increase more of the Metformin or switch to other type of drugs or insulin?
Second question is - to what degree her level of diabetes affect the healing of a wound? She did a minor toe surgery about 3 months ago (removal of partial toe nail due to ingrown toe nail). While most people can heal within 3-4 weeks, her wound still not fully healed yet, although better. She also got infection during the time even though she has taken great care. She worries this is a result of her blood sugar level being high. Also during this 2-3 months, she experienced more frequent blood pressure flunctionation and irregular heart beat. She also could not sleep well and need to use sleeping pill from time to time. I understand lack of good quality sleep is not helpful for diabetes either. I can not say her heart/blood pressure/sleep condition getting worse was entirely due to anxiety but there is certainly some element of this. I hope to clarify the diabetes impact to wound healing, at least to help to dispel any related anxiety.
Thank you!
Helen
First question is - is my mother's condition shows that she has progressed to Type 2 Diabetes? does she need to increase more of the Metformin or switch to other type of drugs or insulin?
Second question is - to what degree her level of diabetes affect the healing of a wound? She did a minor toe surgery about 3 months ago (removal of partial toe nail due to ingrown toe nail). While most people can heal within 3-4 weeks, her wound still not fully healed yet, although better. She also got infection during the time even though she has taken great care. She worries this is a result of her blood sugar level being high. Also during this 2-3 months, she experienced more frequent blood pressure flunctionation and irregular heart beat. She also could not sleep well and need to use sleeping pill from time to time. I understand lack of good quality sleep is not helpful for diabetes either. I can not say her heart/blood pressure/sleep condition getting worse was entirely due to anxiety but there is certainly some element of this. I hope to clarify the diabetes impact to wound healing, at least to help to dispel any related anxiety.
Thank you!
Helen
Brief Answer:
Restrict Toe movements
Detailed Answer:
Good day
Noted your concerns
To answer your questions
1) Answer to your first question:" Yes , she has Type 2 Diabetes. The cut off Hba1c to define type 2 diabetes is 6.5% and her hba1c is 6.8%. Her post meal glucose readings are high and i recommend to increase the Metformin 500 mg tablets to 2 tablets in the morning and 2 tablets at night ( total daily dose of 2 gram per day). This is assuming that her kidney functions are normal and her GFR is above 60 ml
Please explain to your mother that the current level of glucose is not very high.
Ofcourse having adequate sleep and reducing anxiety are extremely important for control of diabetes and will surely help with wound healing
2) Answer to your second question: Her current level of Glucose is not too bad and that might not be the only reason for the delay in healing. Toe nail and leg wounds are very sensitive to movements . The wound will heal faster if you keep the affected area rested without much movements,. You may discuss with your GP or podiatrist to prescribe a toe splint to keep the toe rested limiting the movements.
Also, it is important to avoid wetting the wound. However the wound may need an antibiotic cream just have enough hydration for allowing wound healing. Excess dryness and excess wetting are not good and ,may delay wound healing.
Kind regards
Restrict Toe movements
Detailed Answer:
Good day
Noted your concerns
To answer your questions
1) Answer to your first question:" Yes , she has Type 2 Diabetes. The cut off Hba1c to define type 2 diabetes is 6.5% and her hba1c is 6.8%. Her post meal glucose readings are high and i recommend to increase the Metformin 500 mg tablets to 2 tablets in the morning and 2 tablets at night ( total daily dose of 2 gram per day). This is assuming that her kidney functions are normal and her GFR is above 60 ml
Please explain to your mother that the current level of glucose is not very high.
Ofcourse having adequate sleep and reducing anxiety are extremely important for control of diabetes and will surely help with wound healing
2) Answer to your second question: Her current level of Glucose is not too bad and that might not be the only reason for the delay in healing. Toe nail and leg wounds are very sensitive to movements . The wound will heal faster if you keep the affected area rested without much movements,. You may discuss with your GP or podiatrist to prescribe a toe splint to keep the toe rested limiting the movements.
Also, it is important to avoid wetting the wound. However the wound may need an antibiotic cream just have enough hydration for allowing wound healing. Excess dryness and excess wetting are not good and ,may delay wound healing.
Kind regards
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. LAKSHMI
Answered by
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