Concluded Case

6 cranial nerve palsy in DM T2 patient .

6 cranial nerve palsy ,right side of the patient in clinical photo 2 ,shows that the left eye ball move medially, but the right eye ball should move laterally, but in this second photo the eye ball not move so. With treatment of Biphasic pre meal insulin BID,patient shown good response ,that is seen in the first clinical photo ,in this 1 photo both eye ball moves in the same direction that is Rt eye ball laterally and Lt eye ball medially, showing the cranial nerve of 6th in the Rt side is recovering. This patient in spite of cranial nerve palsy and diplopia patient was not willing for insulin and refused to take insulin so oral anti diabetic was tried but result was not achieved. Patient was educated and pressurised for the meed of insulin then he accepted . With premixed insulin before the meal for twice daily ,patient responded well.to treatment ,6nerve recovers well ,after a 6 weeks later. He was not investigated fully as per modern needs, HbA1c too was omitted for the benefit of patients who was very much poor. Achieving normal glycemia is the mandatory for the , prevention of complication ,and to manage the complication itself. Presence of diplopia was managed by occluding the rt eye and disappearance of diplopia was joy for him and was the sign of 6 cranial nerve recovery, which patient himself reported to me.

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Concluded answer

4 cranial nerve palsy in a diabetic patient was well managed by insulin .Clinically diagnosed without any other support and it was managed at rural clinic.Pt had complete recovery ,and the symptoms of diplopia vanished on 6 weeks of insulin initiation .

All Answers

6cranial nerve palsy in a diabetic patient was well managed by insulin .Clinically diagnosed without any other support and it was managed at rural clinic.Pt had complete recovery ,and the symptoms of diplopia vanished on 6 weeks of insulin initiation .

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