Question
Ten years ago, the patient experienced polydipsia and polyphagia without any apparent cause, accompanied by increased urine output and significant weight loss. A clinic examination revealed elevated blood sugar levels. After taking oral hypoglycemic agents and metformin, there was some improvement. In the past month, the patient has developed numbness in both lower limbs, occasionally with a pricking pain. Bowel movements are normal, sleep is poor. Body temperature is normal, blood pressure is 150/100mmHg. The abdomen is flat and soft, liver and spleen are not palpable, and both lower limbs show collapsible edema. Knee reflexes are absent, Babinski sign is negative. Hemoglobin is 120g/L, white blood cells 7109/L, neutrophils 65%, lymphocytes 35%, platelets 200109/L. Urinary protein ++, white blood cells 0~3 per high power field.
Answer
Based on the patient’s symptoms, diabetes is considered a possibility. For treatment, it is recommended to focus on antidiabetic medications and health education. It is suggested that the patient engage in more physical activity, maintain a regular diet with controlled portions, and closely monitor blood sugar levels.