Uncontrolled DM
Good morning Everyone Male/60yr K/c/o DMT2 C/o Wound in rt leg by Babul's Fork It's healing process going well But uncontrolled Blood sugar 1st Day PPBS -342mg/dl 2nd Day PPBS-325mg/dl Previously Taken Tab Glycomet GP2 BD Tab Vaglimac 0.3mg OD So plz boss suggest line of T/t
A very good afternoon to you. Long standing diabetic people usually have neuropathy, impaired vascularity especially in the lower limbs. So better to switch him to insulin (discontinue secretagogues) for a short period (say upto 1-2mths post healing of wound). Daily dressing of wound with NS irrigation and Mupirocin Oint + Systemic antibiotics coverage as per the pus c/s report. If on plantar aspect, then offloading should be advised.
Do HBAIC Start S/CNovomix 30/70 penfill 16 unit morning 10 unit bed time ,dose should be titratrd according to BSF,PP,Befour dinner blood sugar level Stop Tab Glimipride Continue Metformin Daily dressing of wound with NS irrigationand mupirocin ointment Broad spectrum anti biotic coverage Aerobic anaerobic Offloading should be advised
Try this Tab pioz 15 in the morning Tab glimmer ds TDS Tab voglibose 0.3 in the night Tab tenglia 100 in morning
Dear Dr. Dinesh Vaishnav Sir, Advice for the case. Tab. BGR 34 2 BD.
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