He was a 42-year-old lean, thin, and severely cachectic person. He was a diabetic! His main complaints were severe fatigue and weakness. It's difficult for him to stand up from a sitting position due to his lower limbs' lack of muscle power. He was above 170 cm, but his body weight was only 44 kg! As a diabetic, the first thing that came to my mind was that he was in a severe catabolic state due to a lack of insulin. He was on oral diabetic medicines (3 different kinds of medicines he was on already). He was also having a "diabetic Pen" in his bag to take Insulin. That means he was prescribed Insulin by another doctor before. But, he didn't start or couldn't afford it!
He came for weakness medicines only because he couldn't work due to weakness! I asked him to check his blood sugar first. The result was ready in one hour! It was the highest blood sugar level I have ever seen! The sugar was 824 mg/dl (45.77 mmol/L)! That means, his body was virtually not having any insulin hormone! And, it was one of the acute presentations of diabetes complications!
He needed immediate hospital admission and management for his condition. Unfortunately, he couldn't go to the higher center due to a lack of money, and any support from his sponsor. He left his sponsor for not getting enough salary! He was staying alone without any friends here.
He needed fluids after fluids, insulin via an insulin pump, multiple blood tests at a frequent interval, etc. Those facilities weren't available in my clinic. His oral diabetic medicines weren't helping him at all. He needed insulin management (following discharge from the hospital). Alas, nothing was feasible for him!
I gave one hour of management (one Liter of fluid and subcutaneous Insulin stat dose) but he needed 24 hours of management. I wrote insulin to be bought from the pharmacy. He had no money! He was indeed a helpless guy! I gave him an amount to buy Insulin at least! I advised him to return to his homeland but wanted to work here to support his family!
If he can't buy Insulin, he will die due to acute complications of DM!
Tomorrow I will try to talk with him (if his provided phone remains active) to know his condition, In Sha Allah.
A random and completely unrelated photograph to the text above. I captured it a few days ago in an early morning
