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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diabetes With Great Toe Ulcer.

Plan of care that outlines medical management, surgical management and mechanical management (like Offloading the affected foot) in Open Ulcers? Nature of Patient: Female, 49, Type 2 Diabetes for 7 years, Bilateral Great toe ulcers, Non healing for last 1 year. Right: 2 cm * 1cm, Left: 3 cm* 2 cm Margins: Irregular Depth: Right: ½ cm, Left: ¾ cm Findings: HbA1c: 9%, Vibration Perception Threshold (VPT) & Hot and Cold perception (HCP): Grossly Impaired, Doppler: Normal, Ankle Brachial Index (ABI): Right- 1.01, Left- 0.92 What are the other information do u require from the patient: 1) We need to know about her Educational Qualification, Knowledge of the patient, Sedentary / moderate Lifestyle, Family History, Medical History, Hereditary Medical problem. 2) We need to know whether Medication or Insulin are taken according to the required dosage 3) Dietary Habits 4) Regular Physical workout to control sugar or behavioral modification 5) Her awareness of Daily Hygienic routine regarding Foot care and other personal Hygiene .
Fri, 20 May 2011
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General & Family Physician 's  Response
HbA1c: 9%, shoes poor blood suger control . it has to improve with rest strict blood suger control, broad spectrum antibiotics , provided other diffeential diagnosis like TIO etc should have ruled out clearly.
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Diabetes With Great Toe Ulcer.

HbA1c: 9%, shoes poor blood suger control . it has to improve with rest strict blood suger control, broad spectrum antibiotics , provided other diffeential diagnosis like TIO etc should have ruled out clearly.