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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Type 2 Diabetic Having Bilateral Toe Ulcers

49yrs old female, type2 diabetes for 7 yrs, bilateral great49yrs old female, type2 diabetes for 7 yrs, bilateral great toe ulcers, non healing for last 1 year, HbA1c-9% , VPT and HCP-grossly impaired, ABI:right-1.01, left-0.92 1. what other information do you require from this patient? 2. what is the primary goal of treatment for her? 3. do you think her diabetes control is adequate , and if not what might you suggest? 4. what teaching would you do with this patient? 5. what are the plans regarding treatment of her ulcers?
Mon, 27 Oct 2014
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Geriatrics Specialist,  's  Response
Hi,
Thanks for asking.
Based on your query, my opinion is as follows.
1. Uncontrolled diabetes mellitus is the cause here. Until it is controlled along with evaluation of peripheral arterial disease, recovery wont occur.
2. Controlling HbA1C levels to 5.5-6.5%.
3. No, it is not under control.
4. Change in diet, weight reduction and increasing dosage of medications.
5. Regular sterile dressing can only be done for ulcer. Cause includes both diabetes mellitus and peripheral arterial disease. Unless both are controlled/ treated, ulcer wont heal.
Hope it helps.
Any further queries, happy to help again.
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Suggest Treatment For Type 2 Diabetic Having Bilateral Toe Ulcers

Hi, Thanks for asking. Based on your query, my opinion is as follows. 1. Uncontrolled diabetes mellitus is the cause here. Until it is controlled along with evaluation of peripheral arterial disease, recovery wont occur. 2. Controlling HbA1C levels to 5.5-6.5%. 3. No, it is not under control. 4. Change in diet, weight reduction and increasing dosage of medications. 5. Regular sterile dressing can only be done for ulcer. Cause includes both diabetes mellitus and peripheral arterial disease. Unless both are controlled/ treated, ulcer wont heal. Hope it helps. Any further queries, happy to help again.