Nasar Hida-Diabetes type 2-(Indonesia)-Posted on June 1st, 2017

Name: Nasar Hida
Sex: Male
Nationality: Indonesian
Age: 67Y
Diagnosis: 1.Diabetes type 2 (diabetic peripheral neuropathy; diabetic nephropathy; Diabetic Retinopathy) 2. CHD (post stent surgery)
Date of Admission: December 19th, 2016
Treatment hospital/period: Wu Medical Center/16 days

Before treatment:
Nasar Hida’s right leg was unable to move well in 2007 and his doctor considered him as having lumbar spondylosis so he received lumbar surgery. In 2010, after the surgery, his movement was still bad and during examinations he was diagnosed with diabetes type 2. His doctors prescribed medicines but in 2012 he had to use a wheelchair to move around. In 2013, there were burning feelings in his left leg and he was unable to see objects clearly. Most recently his legs were weak and he could only walk a few steps. He needs help to sit up, stand up and walk. He feels itching in his whole body and especially in his back. He also has an abnormal renal function. He wants a better life so he came to our hospital.
His spirit, diet and sleep are good, his urination function is normal. He defecates once in 3 days.

Admission PE:
Bp: 130/85 mmHg, Hr: 92/min, body temperature: 36.5 degrees. Breathing rate is 19/Min. There is no injury or bleeding spots of his skin and mucosa, the skin was dry and dark. There was a surgery scar in the back around 20cm long and there was a round 10cm scar on his right leg. The patient does not have throat congestion and the tonsils are not swollen. Chest development is normal, breathing sounds of both lungs are clear with no dry or moist rales. The heart beat is powerful with regular cardiac rhythm, there is blowing systolic murmurs of the auscultatory mitral area. The abdomen was flat and soft, with no masses or tenderness. The liver and spleen were normal. The patient had pitting edema of his legs from 5cm up the ankles to the dorsum of the foot. The skin temperature is lower than normal in the legs and  the feet skin color is dark. His fasting blood glucose was around 5-8mmol/L, blood glucose 2 hours after eating was around 12-17mmol/L. BUN was 9.2mmol/L.

Nervous System Examination:
Patient was alert with clear speech. His memory, calculation and orientation ability are normal. Both pupils were equal in size and round, diameter is 2.5 mm. They react well to light and the eyeballs can move freely. There is no nystagmus. Bilateral forehead wrinkle and nasolabial fold are symmetrical and he can show his teeth as normal. Neck muscles are soft. Muscle power of the arms is 5 degrees, the legs 2+ degree The muscle tone of the 4 limbs are normal. Tendon reflex can not be induced by examination. Bilateral Hoffmann sign is negative and palm-jaw reflex is negative. Both sides of Babinski sign are negative. Patient had a sensation decrease of the left foot lateral dorsum. The coordinate movement of the arms is normal. He cannot perform the heel-knee-tibia test because of the weakness of the legs and he cannot do the Romberg’s sign test. The meningeal irritation sign is negative.

After the admission Nasar had a further diagnosis. He received 3 neural stem cell injections and 3 mesenchymal stem cell injections. He also received treatment including the diabetes diet education, a more regular diet, and monitoring of the blood sugar level. There was an adjustment of the oral medicines to improve his blood circulation, adjust the renal function, nerve nourishment treatment and some rehabilitation training exercises.   

After 16 days of treatment the patient's blood sugar level was controlled within an ideal range, the FBG was around 4.2~5.8mmol/L. Two hours after dinner blood sugar level was 7~11mmol/L and his renal function is now normal. The body itching has been greatly alleviated. The muscle power of his legs has increased to level 3 and  he is more energetic.

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