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What's the treatment and management?

52years, female DM-2, HTN, with hypercholesterol, since 4years, presently low grade sancetion of left side feet and hands. Chief Complaints No any other complain. History No any other past history. Vitals BP - 140/80mm/hg Pulls - 70 bpm Spo2 - 98% Wt- 51 kg. Physical Examination Left side lips ( kink uprise)are slightly carve but tongue normal. Investigations Blood and urine test reports are atouched. Diagnosis Please diagnosis Management Please suggest management

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? UNCONTROLLED DIABETES WITH..HT.. AND ..ELEVATED LEVELS OF.. SERUM..CHOLESTEROL & .. TRIGLYCERIDES.. NEED'S.. STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. HT..MANAGEMENT AS IT IS.. STATINS..AS PER REQUIREMENT.. GABAPENTIN .. NEUROTROPHIC VITAMINS.. FOLLOW UP WITH EXPERTS OPINION..

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Uncontrolled DM with Hypercholesterolemia & Hypertriglyceridemia with mild Albuminuria Urine Micral to be performed. If on OADs, then switch to insulin, intermittently adjust the dose as per SMBG till euglycemia achieved. Continue on insulin till HbA1c comes to 7%. After that trial of OADs can be given. For dyslipidemia, Razel-F10 before dinner. Ecosprin 75 after lunch. For neuropathy, Methylcobalamin +Pregabalin +ALA +EPA +DHA OD. Lifestyle Modifications to be strictly followed.

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? UNCONTROLLED DIABETES WITH..HT.. AND ..ELEVATED LEVELS OF.. SERUM..CHOLESTEROL & .. TRIGLYCERIDES.. NEED'S.. STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. HT..MANAGEMENT AS IT IS.. STATINS..AS PER REQUIREMENT.. GABAPENTIN .. NEUROTROPHIC VITAMINS.. FOLLOW UP WITH EXPERTS OPINION..

Tnx Dr Vipin Bihari Jain sir
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To me it looks like a case of “Metabolic Syndrome” comprising of severe degree of T2DM, High Triglycerides, High LDL & mild Hypertension ( For diabetics the target is 130/80) with left side hemiparesis and mild left facial palsy with early signs of renal failure (Proteinuria) Management: SGLT2 inhibitor (Dapagliflozin 10 mg od, Linagliptin 5 mg od, Finofibrate 165 mg od, Rosivastatin 5 mg od, (LDL target should be 50 mg/dl) Aspirin 150 mg od, Basal-bolus insulin. No anti hypertensive is required as SGLT2 inhibitor produces nitriuresis. Along with these diet and exercise remain the basics. Ideally CGM is needed, if not SMBG is good enough for sugar monitoring and dosage adjustments. Interventions may be required depending upon the findings of angio and MRI. Numbness left foot, left hand and facial changes will settle down once glycemic targets are reached. Internal Carotid artery angiogram and MRI brain are needed for assessment and follow up.

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Its diabetic peripheral neuropathy His HBA1C is very high more than 11. He has also.dislipedemia.pl get his cardiac evaluation done ecg 2d echo.Rft with eGFR If his eGFR is more than 44.pl put him on linagliptin 5mg and mpagliflozine 10mg.u can add metformin 500mg bid with Gliclazide 60mg bid For dyslipidemia Rosuvastatin 20mg + finofibrate 160mg. Tab pregabalin 75mg. At bedtime.tab Hosit 1od .pl keep a close watch on his blood sugar by home glucometer

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Uncontrolled DM Dyslipedemia, hypertriglyceredemia Peripheral neuropathy, diabetic Admission, IV insulin, IV NS, atorvastatin, fenofibrate, aspirin . Look for DKA, infection, electrolyte abnormalities . MRI of brain to rule out CVA

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Uncontrolled diabetic Needs to review the line of treatment Rx my advice 1 tab vildagliptin 50mg 1bd Tab dapagliflozin 10mg 1od Tab glycomet sr 500mg bd Tab glimiperide 1 mg bd Bring hba1c down to 7% Sos think of insulin

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With available information it looks like a Stroke Rt MCA territory causing left sensory deficit with left facial weakness. Must do a CT head urgent and ref pt to near by neurologist for further management

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Neuropathy Mostly type2 niddim Hypertensive Hypercholestremia Hyperlypidemia Investigate mri brain with whole spine screening Statin with methylocobalamin

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Uncontrolled T2DM with Diabetic neuropathy with? CVA Controlled sugar (best with insulin ) For dyslipidemia ( statin and diet) Rule-out CVA by MRI

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CT scan brain is the first investigation required to access Vereniging vascular pathology. ECG. Consult Neuro physician with reports

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