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Question:

From Kuala Lumpur, Malaysia:

My 52 year old mother has had type 2 diabetes since giving birth to my youngest brother, who is 16 now. My mother had two of her left toes amputated two weeks ago. The wound is slow to heal, and a few 'blue-black' spots have occurred surrounding the wound. Her doctor had recommended below-knee amputation to save her life! The family refused to give in and is seeking other alternatives. Her main problem is poor blood circulation on both legs. They looked very pale and felt very cold. She had been taking ginkgo biloba supplement and neurobion tablets on top of her normal diabetes drugs. She only started insulin after the operation. Sometimes, she missed her meal and yet her blood sugar levels still range from 16-21 mmol/L [288-378 mg/dl]. The doctor explained that the high readings are due to her infected wound. Is that true? She is also suffering from hypertension, asthma, and a weak heart.

What is the best way to treat the wound to avoid below knee amputation? How can we improve her blood circulation drastically now that she doesn't have much time left before the so-called gangrene spreads upwards? Finally, what kind of moral support can I offer her as she is totally down and keeps repeating that her 'time' has come, and death is just around the corner? This negative attitude has affected her appetite. She always refuse her meals, resulting in her having headaches, constant burping, and vomiting. We need proper advice.

Answer:

Peripheral vascular disease of the limbs is one of the most common chronic complications of Type 2  diabetes as well as high blood pressure, heart failure, and carotid vessels atherosclerosis. Long-standing type 2 diabetes can often require insulin.

Her doctor is telling her the truth when he's affirming that infections increase blood sugar levels dramatically and sometimes surgery is the only solution (even though everything should be done to avoid amputation).

MS

DTQ-20000724074103
Original posting 1 Oct 2000
Posted to Complications

  
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Last Updated: Tuesday April 06, 2010 15:09:14
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