Q: My father has been suffering from diabetes for the past 18 years. He is on insulin injections. Apart from that he takes neurobion injections every 3 months and corvadal A for blood pressure. He takes dytide and hetrazan 100 also. For the past 2 months the swelling on his legs is not reducing. He goes for a daily walk of nearly 3 km. What is the reason for swelling in his legs? How can it be reduced?

A:An elderly gentleman with diabetes mellitus type 2 for 18 years and hypertension having swelling in the feet prompts me to think of diabetic nephropathy. It is a condition where long standing diabetes affects the kidneys. Does he ever get any puffyness over the face or shortness of breath? I think you should get the following tests in him: 1. blood urea 2. serum creatinine 3. serum electrolytes 4. 24 urine proteins and creatinine clearance. You should attempt to acheive a good control over his blood sugar and blood pressure. With the results of above tests you should meet a Nephrologist.