65 yrs male known diabetic r bsl 320 No any other major illness



Dear Dr.Jagannath, Greetings! Your patient needs to be hospitalized to start with. Please conduct a baseline metabolic profile comprising FBS and PPBS, HbA1c, RFT, ECG, FLP and a HEMOGRAM. The 2nd toe definitely looks gangrenous and needs to be amputated , possibly by Ray amputation, if you can call him lucky Better go for a Doppler study for arterial system and we can have a picture of PAD extension. To prevent future ulcers and Amputations, one can give a possibility of by pass surgery. But for present , he needs Basal Bolus Insulin regimen and tight glycemic control, Broad spectrum antibiotics including metronidazole, can Consider even clindamycin in such as these cases. Debridement at earliest, even before the initiation of Insulin. If PAD is an issue, you are bound to screen for CAD. Let us hope that he does not lose his foot !

Thanks for advise Patient admitted & under investigation Sx opinion taken only debridement done Doppler study is showing normal flow in all arterial system Insulin started for hyperglycemia Antibiotics like clindamycin pipracilline with sulbactum also started

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Diabetic nuropathy associated wet gangreen. Control blood sugar, start methycobalamine 1500MCG +gabapentine. if needed start insulin . Dressing with sumag

debridement amputation of 2nd toe antibiotic piperacillin tazobactum clindamycin tight glycemic control arterial doppler

X ray , Doppler , with amputation of 2nd toe n debridement with broad spectrum antibiotics , dont forget to send pus c/s...

Chronic diabetic non healthy by ulcer

Vacum dressing with antibiotics will be helpful

Diabetic foot requiring debridement!! Adv: Start insulin as early as possible!! Send for pus c/s Antibiotics: linezolid plus pipercillin and tazobactum Add amikacin if creat is normal Foot end elevation Daily Aseptic dressings Thank you!

Doppler study may reveal extend of blood vessel blockage,below knee or ankle amputation

Strict control of glucose levels,amputation of 2 nd toe

Dear doc It's as many doctors suggested here,a clear case of diabetic foot. It's difficult to save the second toe which needs disarticulation. The major reason for Diabetic foot being DPN and PVD along with infection following even a trivial injury. So along with other medications a Vasodilator like silostazol 100 mg bid will be of great help.

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