Question

Mr. W. is a 51 year-old black male who lives with his wife and four children. He has been a truck driver for the past 30 years. Three days ago he developed a minor stroke while driving his truck and was rushed to the hospital by a policeman. For the past 10 years, he has been experiencing paresthesia (numbness, tingling) and slower wound healing. But he did not seek medical attention until four years ago when his large toe became infected. After various home remedies without success, he decided to see a physician. He was hospitalized with a tentative diagnosis of diabetes mellitus. After the toe infection healed, Mr. W. was discharged on a diabetic diet and Diabenese (an oral hypoglycemic agent). Over the years he developed a habit of adjusting his medications to his eating habits. During his present hospitalization, a neurology consult revealed severe cerebral atherosclerosis. Renal studies showed decreased functioning of both kidneys.

Select Laboratory Results:

Cholesterol	380 mg/dl
Fasting blood glucose	490 mg/dl
Urinalysis - glucose	4+ glucose
Blood pressure	150/100

Please respond to each of the following in your reply:

1. What would be “normal” levels for the lab results above?
2. What is the relationship between diabetes and his infected toe?
3. What complications did Mr. W develop that are related to diabetes? Name 4 other complications that could occur.
4. When obese individuals with Type 2 DM lose weight their condition often improves. What is the mechanism for this improvement?

Answer 1

Normal levels of above lab finding would be:

Total cholesterol level- less than 200 mg/dl

Fasting blood sugar- 60-100mg/dl

Urine analysis glucose- Nil

Blood pressure-120/80

Relation between diabetic and toe infection:

Uncontrolled diabetes can damage your nerves. And cause lack of feeling called sensory diabetic nephropathy. People often don't feel the cut or sore because of neuropathy. It would get worse and become infected.

Complications that are related to diabetes in these case is-

Cardiovascular problem,stroke

Nerve damage, kidney damage, High blood pressure.

4 other complications would be

Eye complication, ketoacidosis, skin infection, Alzheimer's disease.

When obese people having diabetes mellitus -type-2 often loss weight their condition and improves-

In type 2 cells are unable to access the glucose for their energy. Muscles and organ will be low on energy. Person feel hungry than usual. So the body may start to burn fat and mucle for energy. This causes weight loss.