Dr. Zulfiqar Ahmed
Diabetology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
However, my mother is a known diabetic, defaulted in her medication, leading FBS (fasting blood sugar) level of 17 mg/dl and causing severe weight loss and cataract. She was placed on Insulin Aspart (Novomix), which she took for two months. However, after every insulin injection, she complains of severe pinching pain that radiates from the site of the injection to other body parts (not specific). She stopped the insulin and presently on medication (Amaryl and Galvus met), and it has been more than three months, but she still complains of the insulin injection pain, and it seems to be affecting her sleep and everything. We have seen doctors in my home country, but no one seems to help. Her sugar has been normal for a while, but insulin injection pain is the major problem. Any advice?
Hello,
Welcome to icliniq.com.
You mentioned 17 mg. Maybe you are confused and should be 17 mEq/L, I think. Maybe pain is due to the nerve, which may hit accidentally during injection, especially as your saying it is radiating pain. It may be sharp and like an electric current. If so, she can take Tablet Lyrica (Pregabalin) 75 mg once at night daily. Increase after a week to 150 mg at night. If she does not feel any problems with 75 mg, she may need to continue for few weeks at least. Let me know after a week of taking medication.
Patient's Query
Thank you doctor,
I got the medication, and she has been taking it. Her sleep pattern is better, and the electrical pain is reduced drastically. However, she still complains of itching and mild pain during extreme weather and off, and she has numb feelings on her lower limb. She feels the insulin she took is still moving in her body and sometimes forms lumps in the site of injections given. Her sugar today is 7 mEq/L. I read about the side effects of Lyrica, and it looks scary. So far, we have noticed drowsiness.
Hello,
Welcome back to icliniq.com.
Do not worry about the side effects. It is not that everyone will have these bad effects of the drug. Its statistics about the people who took this medication and if anyone had any abnormal feeling they record it so if someone develops anything we know it is because of this medicine. Her drowsiness will also improve with time, and please continue that. This numbness and pins on her lower limbs are due to diabetic neuropathy, which she developed due to diabetes, and Lyrica is the treatment for it. You need to reassure her that nothing is wrong and the insulin which she took was out of her body in few hours of injecting, and her pains will get better with these lyrics. As I told you, it is not that everybody will get all the bad effects. Please continue the medication, and if she is still on 75 mg, you can increase it to 150 mg at night and use it for more than two weeks.
Patient's Query
Thank you doctor,
So she should continue with the 75 mg for how long, or should we increase the dose? She also complained of panic attacks.
Hello,
Welcome back to icliniq.com.
As she suffered from that pain, she developed a fear of insulin, and when the fear reaches its peak, it can lead to panic attacks. For panic attacks, I will tell you relaxation techniques. Hopefully, it will help her. Sit comfortably with your back straight. Put one hand on your chest and the other on your stomach. Breathe in through your nose. The hand on your stomach should rise. The hand on your chest should move very little. Exhale through your mouth, push out as much air as you can while contracting your abdominal muscles. The hand on your stomach should move in as you exhale, but your other hand should move very little. Continue to breathe in through your nose and out through your mouth. Try to inhale enough so that your lower abdomen rises and falls. Count as you exhale and if you find it difficult to breathe from your abdomen while sitting, try lying down. Put a small book on your stomach, and breathe so that the book rises as you inhale and falls as you exhale. Or simply she can take a deep breath in through her nose and count from 1-7 then pause and then take a deep breath out through mouth and count from 1-11 then pause and repeat it. This she can do multiple times 5-10 depending upon how much is easy for her. Hopefully, this will help her to relax. She should do simple exercises like stretching or even if she can walk for about 30 minutes at least daily. If she still feels stressed, anxiety and panic, please let me know then we will see if some medications can help her. But first, she can try these relaxation techniques.
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