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Question:

From Gettysburg, Pennsylvania, USA:

My father has had type 1 diabetes for several years, and has had many complications over the past two years. He has been working as a teacher for almost 30 years. Because of these complications, he now has to retire with disability. The most recent complications include feet problems and eye problems. He has been hospitalized several times due to staph infections as well. He will soon have to have another eye surgery in just a few weeks.

I am most concerned about a situation that occurred almost a year ago when my father was having a horrible time with his feet. He was put in the hospital with another staph infection. There was something more wrong than just a staph infection. My father's foot was broken and had been broken for several months. He was walking on a broken foot for months and he had no idea, due to not being able to feel anything. The arch of his foot was beginning to break as well. He was put in a cast and has been in a walking cast now for over six months. His foot doctor allowed him to take off his walking cast and wear a regular shoe, but his foot soon began to swell and bruise. He had to be put in the cast again. Recently, he began "water therapy", walking on a treadmill in water. This seems to help a little, but the problem lies deeper. It seems as though his bones, muscles, etc are weaker. Not only is he in a walking cast on his right foot, but his left knee is in a lot of pain as well. One day, my brother gave him a hug and it sounded like a rib broke. My mother had to take him to the ER to make sure he was okay. Luckily, he was, but the doctor has no reasoning for what happened.

The past few nights, my father has been waking up with a blood sugar level of around 57 mg/dl [3.2 mmol/L] The doctor has decreased his insulin level, but I worry about what this sudden decrease in blood sugar level could do to him. He is also retaining a lot of fluid and now weighs almost 300 pounds. He cannot exercise because of his foot and because of high blood pressure. He may soon have to start dialysis or possibly be put on a kidney transplant list.

I am a very frustrated daughter. I am 19 years old and feel like my father is "disappearing" before my very eyes. I know that the doctors are doing all that they can, but I feel that it is not enough. Have you heard of any of these symptoms before? Do you have any advice on what he can do for it (weak bones, etc.)? I don't know if there are any answers, but I am willing to hear anything. I want my dad to be around long enough to see his three kids get married and to see his grandchildren, and I will do anything I can to help him out. I am not trying to give a "sob-story", but merely wanting to know if there is anything else we can do.

Answer:

Your father seems like he has had a tough time with his diabetes. Many of the symptoms and problems you describe are, unfortunately, familiar to me. It is known that individuals who have kidney involvement also have decreased clearance of their insulin and require less over time. If the insulin is not decreased, hypoglycemia is a real threat. In addition to the kidney problems, the bones can become brittle. The neuropathy sounds bad in that he cannot feel his feet. He will have to look at them every day to make sure no problems begin or run the risk of a very severe limb-threatening infection.

One of the things that may help you is to acquire more information regarding diabetes and kidney problems associated with diabetes. There are a number of on-line services you can contact, including the American Diabetes Association website, for more information. I would also suggest you try to contact the diabetes care unit at your local hospital. They can offer you additional services available in your area.

JTL

[Editor's comment: For more information regarding diabetes and kidney disease, please see: Guidelines to Help Protect Kidney Function and Complications: Kidneys.

For more information on diabetic neuropathy, please see: Diabetic Neuropathy and On-line Diabetes Resources Part 15: Diabetic Neuropathy. All of these can be found at the Diabetes Monitor. SS]

DTQ-20010128155916
Original posting 2 Feb 2001
Posted to Complications

  
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Last Updated: Tuesday April 06, 2010 15:09:18
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