Q: I am 66 years old and suffering from diabetes for the last 10 years. My sugar level is in control. Fasting is 125 and post prandial is 150 mg/dl. I am a rice eater in lunch. My breakfast comprises of 5 idlies and sambhar. At night I take 3 rotis with sabzi. I take 4-5 cups of tea every day. I weigh 85 kg and I am 5 feet 8 inches tall. I am a pure vegetarian. I used to ride the stationary cycle for one hour and walk for nearly 40 minutes covering 4 to 5 km till last month. But suddenly I started getting pain in my left leg and the muscle below the knee is becoming painful. I have no problem while walking on the road or in the house. But when I press the muscle, there is little pain. On road I am not able to walk fast and am compelled to stand after every ten minutes. I am able to climb stairs without any difficulty and can drive easily. I can do all household chores comfortably. I am taking Daonil twice along with Metformin 500 mg before breakfast and dinner and Rosiglitazone 2 mg with Metformin 500 mg at 1 pm daily with B complex. The local doctor advised me to take Gabapentin 300 mg with Methylcobalmin 500 mg, folic acid 1.5 mg and Pyridoxine hydrochloride 3 mg. Am I suffering from diabetic neuropathy. What should I do to get rid of the pain?

A:I note that you have long-standing diabetes, which, with your present treatment, seems satisfactorily controlled. I note also that you develop pain in the left leg below the knee (I presume in the calf) after ten minutes of slow walking on the road, after which you need to stand still in order for the pain to disappear before you can walk again. First of all, these are not symptoms of neuropathy, and I think you could reasonably stop taking all the medications relating to pain relief, since I doubt they would give you any significant help. The condition sounds like what we call intermittent claudication, which is due to limitation of the circulation in that leg. In order to establish the diagnosis, you would need a careful examination of the vascular system in that leg, and that would normally include special tests. You would need to see a specialist for this, and only after a full assessment has been made could the plan of treatment be established. There are of course other causes of leg pain on walking, and they would also need careful consideration by the examining specialist. I do hope this advice is of some help to you.