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My father is a diabetes patient who lives in South Asia. He

is looked after by my...
My father is a diabetes patient who lives in South Asia. He is looked after by my brother who is a physician (pathologist) there.
My father is currently having some issues with Neuropathy. Since I live in Canada, my brother asked me to consult with a physician from North America as he thinks there may be advanced medicines to help my father. My brother sent me the case history of my father and he also sent two questions. Please read them and any answer would be appreciated.
Best regards.
-------------------------------------------------------------------------------------------------------------------------
Patient details:-
Age: 66 yrs Sex: male
Weight: 59 kg, height: 1.74 meter.
-------------------------------------------------------------------------------------------------------------------------
Chief complaints:-
1. Severe weakness and parasthesia for 6 months.
2. Severe Gastric irritation for 6 month.
3. Burning sensation of whole body all day long during gastric exacerbation.
-------------------------------------------------------------------------------------------------------------------------
History of present illness:-
1. DM for 20years. RBS is within normal limit with medication of soluble insulin.
2. Neuropathy and Gastroperesis due to long time DM.
-------------------------------------------------------------------------------------------------------------------------
History of past illness:-
1. Steven-Johnson syndrome 30 yrs back.
-------------------------------------------------------------------------------------------------------------------------
Drug (medication) history:-
1. Sulpher sensitive patient
2. Now patient is taking the following drugs:
a. Insulin. Mixtard 30 (22+0+6unit)
b. Tab. Neuro B( Vit B1+B6+B12)
c. Tab. Mecobalamin.
d. Cap. Rabeprazole.
e. Tab. Flupenticzole+ Melitracin
-------------------------------------------------------------------------------------------------------------------------
Question:-
1. If there any supplement preparation that can reduce the symptom of Neuropathy and gastroperesis?
2. If there any enzyme preparation that can help in digestion of a patient of gastroperesis and reduce the symptom of gastric irritation?
------------------------------------------------------------------------------------------------------------------------
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Answered in 10 hours by:
5/8/2013
Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Endocrinology
Satisfied Customers: 11,451
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
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Hi. I am online and available to help you. Thank you for your patience.
Let me review your note in detail. Be right back.
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Customer reply replied 4 years ago

Thanks. I look forward to your comment..

Let me answer your questions in order:
1. As it is not clear from the clinical notes all the therapies that have been tried to help with diabetic neuropathy, and the possible therapies involved a very long list, here is a link to clinically proven treatments as well as a ranking of how good the medical literature supports the use of any specific therapy:
http://www.aan.com/globals/axon/assets/8400.pdf
2. There is no specific enzyme preparation that can solve your fathers gastroperesis and reduce his symptoms of gastric irritation. That being said, there have been great strides made in the last few years in the treatment of this condition. Once all the possible choices and reasons for the various therapies is too long for me to type out, but here is an excellent article that discusses, in depth, the treatment guidelines that are backed up by the most uptodate clinical studies. This article is pretty complicated but I am sure your brother will able to get through it:
http://gi.org/guideline/management-of-gastroparesis/
Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?
I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.
Thanks in advance,
Dr. Rick MD FACS
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Customer reply replied 4 years ago

Thanks Dr. Rick. I've sent your response to my brother, including the articles.

Since I am not a medical person, I also asked him to rate your response and for any question or comment that he may have.

Regards.

I will look forward to his reply, any further questions he might have and the opportunity for positive feedback.....
Ask Your Own Endocrinology Question
Hi.
Have you had a chance to speak to your brother to see if he thinks I should be rated positively for my assistance?
It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
I hope your father is doing better. Have a good day.
Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Endocrinology
Satisfied Customers: 11,451
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
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Dr. Rick, MD
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Satisfied Customers: 11,451
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