Conversation: The conversation between human and AI assistant.
[|Human|] I am a diabetic patient since last 12 years. I am on 30/70 human insulin and used to take 8 units every before lunch since last one and half years as prescribed by Enchronologist at Narayana Hrudhalaya, Bangalore. By the way, I am 67 years old. Before that, I used to take 3 mg Glimpiride tablet. On 08.12.2010, I put on my shoes and walked for about one and half mile. While walking I did not feel any pain in my feet. But after coming home and openining my shoes,I started feeling severe pain on the big toe of my left foot. Next day, I got my blood sugar tested and found the blood sugar Fasting 124 and PP 239. I immdiately consulted my physician and he diagnose the foot infection as pyronachia and prescribed some antiboitic tablet. Healso incresed the does of insulin taking 15 units before breakfast and 8 unit before dinner and advised me to test the blood glucose after 1 week. When I got my blood glucose tested, the fasting went upto 200 and pp 305. The doctor advised me get the infection surgically treated. So I got the ulcer operated and half of my big toe nail was cut. The surgeon prescribed me to take Percin antiboitic tabelts.After 1 week, I got my blood sugar tested and Fasting came down to 143 and PP 257. I took about 20 percin tablets but the ulcer has not yet been healed. My physician advised me to continue the percin tablets. But when I went to the surgeon for dressing, he suggested me to discontinue taking percin tablet. As the wound has not been completely cured, I consulted another Enchronlogist,who has suggested to check my pp blood sugar.Accordingly I got pp blood sugar tested and it has come down to 158. But the would has not been completely healed and I have to get it dressed every 3 days. I would like to be advised what action is now to be taken and since the ulcer is not curing,is there any possiblity of its turning to Gangrene?
[|AI|]  HI Thanks for posting your query.  Your blood sugars are now controlled, so continue Insulin at 15--0--8 dose only. As of your ulcer is concerned, wound healing is always delayed in diabetics.  Most common causes for delayed wound healing are uncontrolled blood sugars (which is controlled in your case) or persisting infection at the wound site.  Though you have taken antibiotics the infection might have not yet been cured. I advise you to get a test called Wound swab culture sensitivity test which will detect if any infection is persisting in the wound and also will give information on which antibiotic is useful for that infection. Kindly get the test done and revert with report. Any clarifications feel free to ask. Regards.