Q: My mother is a diabetic since the last 10 years. She is on insulin treatment since last year. She was using 50/50 Insulin, but since last week our doctor had prescribed her to use 30/70 insulin. Of late, she has been experiencing swelling in the face and legs during evenings. She has been treated for urine infection recently. Could the infection be a reason for the swelling or is it because of the insulin/blood sugar level? Could you please suggest a proper treatment for this problem?

A:Some of the causes for the swelling are hypothyroidism, low serum proteins, renal failure and a drug allergy. Your mother should get investigated for these problems and revert to her doctor for further management. In addition, of course it is very important to keep the diabetes under control, by means of monitoring blood sugars at home regularly, and checking glycosylated haemoglobin every 3-4 months. Also remember, diabetes is a chronic disorder with several ramifications. It is not just a sugar disease. Your physician has to make sure she is monitored for associated problems like high BP, high lipids, etc; and for chronic complications apart from kidney function, eg eye problems (esp in the retina), heart function, etc. Finally, since she is post menopausal, I hope she is taking adequate dietary and supplemental calcium and Vitamin D.