My mother is diabetic, and she is feeling tired, restless, and sleepy, and there is weight loss. Why?

Hello,

Welcome to icliniq.com.

What all medications is she on? How much weight has she lost? Is there any fever, coughing, burning urination, recent constipation or diarrhea, etc.? Do you frequently monitor her sugar level at home? Has her diet gone down recently? You probably have not attached all the reports like CBC (complete blood count), Vitamin D, HbA1c (hemoglobin A1c), etc. In the attached reports (attachments removed to protect the patient's identity), her CRP (C-reactive protein) is elevated, the iron profile is deranged (suggestive of iron deficiency), calcium is low and alkaline phosphatase is elevated (suggestive of Vitamin D deficiency). So please attach her CBC report for hemoglobin level, which is probably low. She will need iron supplements like syrup Haem Up (Ferrous Ammonium Citrate) or Dexorange (Cyanocobalamin and Ferrous ammonium citrate and Folic acid) two teaspoon or tablet like Fericip XT (Ferrous Ascorbate and Folic Acid) two to three times a day according to her tolerance, after meals. Next, her Vitamin D is probably low, too, so get Vitamin D tested, and she will need Vitamin D supplements as well. Elevated CRP is usually an indication of some sort of infection in the body but does not specify exactly which. So we have to investigate according to symptoms. But such mild elevation is frequently due to laboratory error as well. So it should be confirmed once in repeat CRP level and additional undergoing ESR (erythrocyte sedimentation rate) level (which is similar investigation). If she has lost significant weight in the last one month, you should get her checked once by the local doctor as well, as the further investigation will have to be done according to symptoms and examination findings. One more thing is that we have to rule out the possibility of low blood sugars due to medications (especially if her diet has gone down recently). So whenever she is having those symptoms of restlessness (prominent), you should get her sugar tested at that time if you have a machine at home. It would help if you also got her HbA1c tested to get an idea about sugars in the last three months. So, one nearby doctor visit for examination will be necessary. I hope this helps you and get back if you have any doubts or more information to share.

Hello,

Welcome back to icliniq.com.

Her ESR and CRP are normal. However, hemoglobin and vitamin D are quite low. HbA1c is also quite normal, which means we should rule out the possibility of intermittent low blood sugar levels as well. So sometimes get her sugar tested in the morning before eating anything as well. Now for her hemoglobin, you should start her on tablet Fericip XT (Ferrous ascorbate and Folic acid) or other iron supplements two to three times a day according to tolerance. It may be started once a day, and you can increase it gradually. She should also take foods rich in iron, like green leafy vegetables. For vitamin D, she should take supplements like tablet Uprise D3 (Vitamin D3) or Calcirol sachet (with milk) 60,000 units once a week for eight weeks and subsequently once a month for the next six months. All the best.