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What Causes Recurring Problems In Foot Despite Having Normal Blood Sugar Levels?
Question: My 64 years old Mother-in-law, has gone through an amputation of part of one toe finger, now after a year she is having problem with her second foot. She is also having rheumatoid arthritis and her blood count is very low (reports attached). Last time the doctor had said it was diabetic foot now another doctor says it is not diabetic , as her sugar fasting and random and HbA1C is normal. The second doctor says it is because of low blood count and reduced blood supply to her legs as she does not walk and is resting most of the time. However, the first doctor says HbA1C can be showing normal because of low blood count. Please advice, photos and reports in PDF file, please download here:
https://www.dropbox.com/s/puh6fq7mcdyfeuw/Sadhana%20Samajder%20reports%20and%20foot%20pictures.pdf
https://www.dropbox.com/s/puh6fq7mcdyfeuw/Sadhana%20Samajder%20reports%20and%20foot%20pictures.pdf
Brief Answer:
Kindly upload scanned format of test reports.
Detailed Answer:
Hi,
I understand your query and concern.
I need to go through the reports before making a diagnosis.
There is a frequent technical error encountered while going through the URL provided by you.
So I request you to upload the scanned reports in the upload report column in a space which is provided to left of your question.
Thank you.
Kindly upload scanned format of test reports.
Detailed Answer:
Hi,
I understand your query and concern.
I need to go through the reports before making a diagnosis.
There is a frequent technical error encountered while going through the URL provided by you.
So I request you to upload the scanned reports in the upload report column in a space which is provided to left of your question.
Thank you.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Please help doctor view my report
Brief Answer:
Possible Diabetic Gangrene-Secondary to reduced blood supply.
Detailed Answer:
Hi Mam,
I have gone through your uploaded reports and images as well.
The reports reflect low Hemoglobin and near normal level of blood sugar.
Also serum creatinine is high and relative low levels of lymphocyte count.
In spite of low hemoglobin and low lymphocyte count(both of which are directly related to the disease course of RA),the cause of toe changes are related to the is-chemic(reduced blood supply) changes secondary to longstanding Diabetes.
This is called Diabetic Gangrene which can occur even in presence of normal sugar levels,through a process called Diabetic Vasculopathy and Neuropathy(blood vessel and nerve damage in diabetes).
Low Hemoglobin only aids in the process ,but does not directly contribute to it.
Hence the opinion of your second doctor is scientifically correct.
I advise you to seek his help.
A consultation with a Chiropodist and a General Surgeon will help.
Post your further queries if any.
Thank you.
Possible Diabetic Gangrene-Secondary to reduced blood supply.
Detailed Answer:
Hi Mam,
I have gone through your uploaded reports and images as well.
The reports reflect low Hemoglobin and near normal level of blood sugar.
Also serum creatinine is high and relative low levels of lymphocyte count.
In spite of low hemoglobin and low lymphocyte count(both of which are directly related to the disease course of RA),the cause of toe changes are related to the is-chemic(reduced blood supply) changes secondary to longstanding Diabetes.
This is called Diabetic Gangrene which can occur even in presence of normal sugar levels,through a process called Diabetic Vasculopathy and Neuropathy(blood vessel and nerve damage in diabetes).
Low Hemoglobin only aids in the process ,but does not directly contribute to it.
Hence the opinion of your second doctor is scientifically correct.
I advise you to seek his help.
A consultation with a Chiropodist and a General Surgeon will help.
Post your further queries if any.
Thank you.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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