Clinical Cases

Diabetes Mellitus Type 2 with Advanced Mononeuritic Multiplexa with Proliferative Diabetic Retinopathy

Drs. Sunil R. Thumar and Jagdish Thebar present a case of diabetes mellitus type 2 with advanced mononeuritic multiplexa with proliferative diabetic retinopathy.

Date: 13.02.2021
Patient name: XYZ
Age: 52yrs. / Female
Religious: Hindu (Brahmin)
Occupation: Housewife
Address: Goner, Jaipur
Diagnosis: T2DM with Advance Mononeuritic Multiplexa with Proliferative Diabetic Retinopathy

Patient’s Detail:
52/F Pt. having diagnosed complaints of TY2DM + Hypothyroidism with sensory neuropathy and recently twice having hypoglycemic episodes. Patient came from religious background. Due to psychiatric and college reception staff reference she came here for the treatment of blood sugar management.

Physical appearance:
Tall and heavy body, white skin, dark brown small eyes, dark hair without use of artificial colors, low pitched voice.

Chief complaint:

  • Pain in extremities
  • Stitching pain in sole
  • Muscular cramps (calf muscle + fingers both and B/L UL and LL) in night, amelioration by walking and pressing local part.
  • Blurred vision since 8-10 years (not able to see clear view 20-30 ft. long distance God’s eye in temple)
  • Joint pain especially knee joints which aggravate by walking, increased strain and amelioration by sleeping

Past History:

  • Recently 2 episodes of hypoglycemia
  • Hypothyroidism before 10-15 yrs. ago
  • Cholilithiasis (open laparotomy before 30 years ago)
  • B/L Pedal edema before 3 years ago and admitted in MGH

Drug History:

  • METFORMIN + GLIMIPRIDE
  • THYROXINS (100mcg) stopped since few yrs.

Mental Symptoms:

  • Extreme religiousness (half hour for prayer/mala/puja/gita/chalisha and all the day seva to god and bhakti)
  • Tension due to her son’s engagement/financial/family
  • Fear snakes
  • Anger suppression
  • Weeping while alone
  • Introverted
  • Reserved personality

Dreams:

  • Religious music, weeping, snakes, religious

Physical Generals:

  • Appetite : increase main meal 2 time , small meal 3-4 time
  • Thirst : thirsty, intake small quantity with small interval
  • Desire : sweets++, rice, milk ++
  • Aversion : sour, pickles
  • Stool : once a day with satisfactorily
  • Urine : D(5-7 Time), N(2-3 Time)
  • Perspiration : increase, salty smell
  • Bathing pattern regular
  • Thermal Reaction : Hot
  • Sleep : 7-8 hr./day with supine position, talk in sleep, sensitive sleep
  • Menstrual History: menopause since 10 yrs.

Systemic Examination:

Totality of symptoms:

  • Mental generals
  1. Religious nature
  2. Weeping while alone
  3. Fear of snakes
  4. Reserved personality
  5. Remorse
  6. Dreams of snakes/weeping/religious
  • Physical particular
  1. Sweet desire
  2. Milk desire

Rubric:

  • MIND – FEAR – snakes, of
  • MIND – WEEPING – alone, when
  • MIND – RESERVED
  • MIND – REMORSE
  • MIND – RELIGIOUS AFFECTIONS – too occupied with religion
  • DREAMS – SNAKES
  • DREAMS – WEEPING; about
  • DREAMS – RELIGIOUS
  • GENERALS – FOOD and DRINKS – milk – desire
  • GENERALS – FOOD and DRINKS – sweets – desire

Reportorial Analysis:[1]

Remedy selection:

  • Physical appearance
  • Fear, dream, religiousness highly indicate Lachesis
  • Religious imagination is also prominent
  • In general case receiving we observe great loquacity and center of talk is GOD.
  • So, we rule out from Nat. Mur.

Potency selection:

  • We give 200 potency according to susceptibility

Prescription:

  • Lachesis 200 single water dose on 13.02.2021
  • Follow up:
DATE SYMPTOMS PRESCRIPTION
03.03.2021 •      100% Relief in stitching pain
•      No muscle cramps
•      Vision improves (see 20-30ft. Distance vision clear)
•      @ home RBS – 186 mg/dl
•      @ hospital RBS – 158mg/dl
•      Adv. Tab. Metformin (500mg) half BD
P.L. 200/3 before meal for 20 days
22.03.2021 •      Reddish skin without itching aggravation in Summer on abdomen and take Inj. Avil (1amp) IV before 6-8 days
•      No stitching pain/muscle cramps
•      Better in vision as previous
•      @ hospital RBS – 158mg/dl
P.L. 200/3 before meal for 7 days
01.04.2021
(10:44 AM)
Telephonic review
•      Vision improves
•      No other complaint
•      @ home FBS – 94mg/dl
•      Adv. Tab. Metformin (500mg) half OD
P.L. 200/3 before meal for 30 days
08.05.2021
(03:11PM)
Telephonic review
•      No extra complaint
•      @ home fasting 114 mg/dl
•      2 hrs. PP – 120mg/dl
P.L. 200/3 before meal for 7 days
11.05.2021
(10:08AM)
Telephonic review
•      No other complaint
•      @ home 2 hrs. PP – 150 mg/dl
•      Adv. Metformin (500mg)……Stop
P.L. 200/3 before meal for 30 days
16.06.2021
Telephonic talk
•      Craving sweet things and take also yesterday than blood sugar
•      @ home on 15.06.2021
2 hrs. PP – 160mg/dlFBS – 96 mg/dl
P.L. 200/3 before meal for 7 days
26.06.2021
Telephonic talk
•      @ home FBS – 98 mg/dl
•      2hr PP – 139mg/dl
P.L. 200/3 before meal for 30 days
22.07.2021
Telephonic review and talk
•      Blood sugar not done due to out of town
•      No other complaint
P.L. 200/3 before meal for 30 days

 Reports:

13/02/2021:

03/03/2021:

22/03/2021

Conclusion:

  1. Rapid improvement in vision.
  2. Also get rapid improvement in neuropathy.
  3. Oral hypoglycemic agent stop.
  4. Fasting blood glucose is under normal range.
  5. Borderline or below level of 2 hrPP glucose .
  6. Fill happy and no other associated complain.
  7. All those improvement after given single dose of LACHESIS.

Reference:

1. RADAR 10 Access to Synthesis 9.0 (English)(CE90)

About the author

Sunil Thumar

Dr. Sunil R. Thumar M.D. (Medicine) Hom. PGR and P.G. Diploma in Diabetes, Researcher in Diabetes. Prof. and H.O.D., Department of Practice of Medicine, Swasthya Kalyan Homoeopathic Medical College & Research Centre, Jaipur, Rajasthan, India.

About the author

Jagdish Thebar

Jagdish Thebar M.D. (PGR), Department of Practice of Medicine, P.G. Diploma in Diabetes, Researcher in Swasthya Kalyan Homoeopathic Medical College & Research Centre, Jaipur, Rajasthan, India.

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