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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Diabetic Nephropathy In The Hands And Legs Be Treated?

My brother, age 71, has had type II diabetes since 2002. He now has advance nephropathy in his feet/legs/hands; however his blood sugar has remained basically stable with decent numbers. His condition is worsening. He s having kidney problems and is not urinating enough and has little/no control over his bowels. He has been hospitalized/in a rehab center for the better part of a month. Still no diagnosis.
Tue, 27 Feb 2018
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Pathologist and Microbiologist,  's  Response
Hello,

As your brother's age was 71 and was a type 2 diabetic, there are more chances of renal damage (nephropathy). Nephropathy (persistent albuminuria >300 mg/dl) related to kidney and not related to feet, legs hands. Only the outcome may be seen in hands and legs as swelling.

Coming to brother's condition, the most probable reason might be renal damage (defect infiltration) which leads to swelling of legs and hands. Legs and hands will be effected in neurological damage due to diabetes.

Diagnosis and extent of nephropathy can be confirmed by the below investigations:
1. Blood glucose levels (FBS, PPBS)
2. Renal function tests (blood urea, serum creatinine, electrolytes)
3. Urine analysis (albumin sugar, micro)
4. Ultrasound abdomen
5. Complete blood picture

Coming to the treatment part, you have to follow the below:
1. Control of blood sugar levels
2. Angiotensin-converting enzyme (ACE) inhibitors (captopril, enalapril) can be used
3. Avoid metformin
4. Check other risk factors, hypertension, alcohol, smoking
5. Maintain a good lifestyle


Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Vamsi Krishna Chittimoju
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How Can Diabetic Nephropathy In The Hands And Legs Be Treated?

Hello, As your brother s age was 71 and was a type 2 diabetic, there are more chances of renal damage (nephropathy). Nephropathy (persistent albuminuria 300 mg/dl) related to kidney and not related to feet, legs hands. Only the outcome may be seen in hands and legs as swelling. Coming to brother s condition, the most probable reason might be renal damage (defect infiltration) which leads to swelling of legs and hands. Legs and hands will be effected in neurological damage due to diabetes. Diagnosis and extent of nephropathy can be confirmed by the below investigations: 1. Blood glucose levels (FBS, PPBS) 2. Renal function tests (blood urea, serum creatinine, electrolytes) 3. Urine analysis (albumin sugar, micro) 4. Ultrasound abdomen 5. Complete blood picture Coming to the treatment part, you have to follow the below: 1. Control of blood sugar levels 2. Angiotensin-converting enzyme (ACE) inhibitors (captopril, enalapril) can be used 3. Avoid metformin 4. Check other risk factors, hypertension, alcohol, smoking 5. Maintain a good lifestyle Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Vamsi Krishna Chittimoju