Q. Can diabetes make my hands itchy and numb?

Patient's Query

Hello doctor,

I am suffering from anxiety and depression from past few years. I took various antidepressants. Now I am taking Vilazodone, one tablet in the morning and Lonazep 0.25 mg from last ten days. But I am having breathlessness and palpitations when I do any small physical activity and irritability. My hands get numb, and itching occurs on my hands and legs. I guess it is because of diabetes. I feel my chest is heavy, and my legs and back pains a lot. My sugar level is 130 fasting and 235 postprandial. I am taking Glimisave M. My sugar levels fluctuate badly, and my HbA1c is more than 7, a few months back. I think due to sugar intake it is out of control; otherwise, it is normal. I have very low energy due to depression medicines, and I am very drowsy, and irritability does not reduce. I have negative thoughts, and my hands get numb. I have a habit of chewing tobacco. Please, advice some treatment.

Doctor's Answer

Dr. Ashok Kumar Choudhary
M.B.B.S., M.D. PSYCHIATRY
Andrology, Geriatrics, Psychiatry, Psychologist/ Counsellor, Psychotherapy, Sexology

Hello,

Welcome to icliniq.com.

I am sorry to know that despite the best efforts you are not responding with current antidepressants and there are active symptoms.

I suggest the following treatment given a diagnosis of diabetes with depression.

Tablet Duloxetine (Duzela M) 30 mg in the morning and 30 mg in the evening. The reason for recommending this medicine is because it is quite effective for pain symptoms associated with diabetic neuropathy along with depression.
Tablet Aripiprazole (Arpizol) 5 mg in the morning. Although it comes from an antipsychotic group of medicines, my purpose here is to augment the action of antidepressants while addressing anger associated with depression.
Tablet Lonazep (Clonazepam) can be continued as per the current level if there is adequate sleep. In case sleep has been an issue despite the medicines, I will recommend upping the dose of Lonazep to 0.5 mg at bedtime.
Regarding Vilazodone, I think it should be removed as it is causing intolerable side effects. Also, this particular antidepressant has little role in pain associated with neuropathy, and I think Duloxetine will be a better option.
There is need to stop tobacco. This is because many of the medicines mentioned above have poor efficacy when tobacco is consumed.

You need to consult your diabetes doctor, as poor control of diabetes could be a significant reason for the poor response. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent.

In case you have more questions, feel free to write back to me.

For further queries consult an andrologist online --> https://www.icliniq.com/ask-a-doctor-online/andrologist

Patient's Query

Thank you doctor,

I am feeling very drowsy after taking Duzela M 30 mg and Arpizol 5 mg.

Doctor's Answer

Dr. Ashok Kumar Choudhary
M.B.B.S., M.D. PSYCHIATRY
Andrology, Geriatrics, Psychiatry, Psychologist/ Counsellor, Psychotherapy, Sexology

Hi,

Welcome back to icliniq.com.

I suggest taking the capsule Duzela at night. Generally, it is nonsedative, but 10 to 20 % individuals report drowsiness after using it. In this situation, it is recommended to take it at night, 30 minutes before bedtime.

I must assure you that it is not a serious side effect and it is likely to disappear in few days.

For more information consult an andrologist online --> https://www.icliniq.com/ask-a-doctor-online/andrologist

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