Q: I am a 71 years old type 2 diabetic woman and have hypertension for the last 15 years. I had a bypass surgery CABG operation three months back. After the operation, my serum electrolyte levels were are fluctuating for the last 2 months. Currently, Na+ is 133 and K+ is 4.1. Also, my blood sugar level is high (fasting – 100 mg/dl to 120 mg/dl, PP – 200 mg/dl). I am taking Galvus 50, Amaryl 1mg, Volix 3 and 14 units of Lantus injection every day. My urea and creatinine levels have also increased to 0.81 and 1.17 respectively. There is some swelling in my left foot too. Does this indicate that I am having a kidney problem? How should I proceed? Please advise.

A:A combination of heart failure due to coronary artery disease and hemodynamic imbalances during surgery can lead to electrolyte imbalances and renal insufficiency as described by you. In addition, hypertension and diabetes compound the problem. Leg swelling could be a sign of heart failure as well as kidney problem. Since you recently had coronary bypass surgery two months ago, first you should see your cardiologist for optimizing the treatment for heart failure and hypertension.

For your diabetes, I would suggest increasing the dose of Amaryl after consulting with your endocrinologist.