Elderly Man Suffers from Blurred Vision and Numbness—The Hidden Dangers of Uncontrolled Type 2 Diabetes
Living with type 2 diabetes can be a silent battle, especially when symptoms creep in gradually over years. This is the story of a 65-year-old man who experienced blurred vision and numbness in his limbs—not due to aging, but as a direct consequence of poorly managed type 2 diabetes. After more than a decade without consistent treatment, he finally sought medical help when complications became too severe to ignore. His journey highlights the importance of early intervention, patient education, and comprehensive care in managing chronic metabolic conditions.
A Patient's Long Road to Diagnosis
Patient Profile: Male, 65 years oldDiagnosis: Type 2 Diabetes with Diabetic Neuropathy and RetinopathyHospital: Beijing HospitalDate of Admission: May 2021Treatment Plan: Combination therapy including Metformin, Insulin Glargine, Acarbose, Rosuvastatin, Telmisartan, Nifedipine, Xuesaitong Injection, Alpha-Lipoic Acid, and Calcium DobesilateTreatment Duration: 14-day inpatient stay followed by one month of outpatient follow-upOutcome: Significant improvement in blood glucose levels, resolution of neurological and visual symptoms
Initial Consultation: A Decade of Neglected Health
The patient first noticed symptoms such as dry mouth and skin itching about ten years prior. At that time, tests revealed an elevated fasting blood glucose level of 9.3 mmol/L, postprandial glucose at 9.8 mmol/L, and HbA1c (glycated hemoglobin) of 7.1%. He was diagnosed with type 2 diabetes and started on oral medications—Metformin and Repaglinide. However, after only three months, his control remained suboptimal: fasting glucose dropped to 7.1 mmol/L, but post-meal levels spiked to 13.6 mmol/L, and HbA1c rose to 8.4%.
Despite medical advice, the patient refused insulin therapy and intermittently took medication, often adjusting doses on his own without consulting healthcare providers. Over time, new warning signs emerged: blurred vision developed three years ago, followed by numbness in both lower limbs—one year ago—more pronounced on the left side. There were no signs of infection or nighttime pain, so he delayed seeking further evaluation.
Worsening Condition Triggers Hospitalization
During this visit, lab results showed alarming numbers: fasting glucose had soared to 12.61 mmol/L and HbA1c reached 10.3%, indicating long-term poor glycemic control. Physical examination revealed high blood pressure (160/90 mmHg), mild edema in both legs, and reduced dorsalis pedis pulse on the left foot—early signs of peripheral vascular disease. Neurological assessment was negative for Babinski sign, but sensory deficits pointed toward diabetic neuropathy.
Given his history of hypertension and hyperlipidemia—both managed partially with antihypertensive drugs like Valsartan and Amlodipine—he was admitted for comprehensive management. The final diagnosis included:
- Type 2 Diabetes with Peripheral Neuropathy and Diabetic Retinopathy
- Stage 2 Hypertension (Very High Risk)
- Hyperlipidemia
Comprehensive Treatment Strategy
Upon admission, ophthalmology consultation confirmed significant retinal damage: widespread microhemorrhages in the fundus, characteristic of advanced diabetic retinopathy. Laser photocoagulation was recommended to prevent further vision loss.
After extensive discussion, the patient finally agreed to initiate insulin therapy—a crucial turning point in his treatment plan. His regimen now included:
- Insulin Glargine via subcutaneous injection for basal insulin support
- Metformin to improve insulin sensitivity
- Acarbose to manage postprandial glucose spikes
- Rosuvastatin for lipid control
- Telmisartan and Nifedipine SR for dual blood pressure management
- Intravenous Alpha-Lipoic Acid to nourish nerves and alleviate neuropathic symptoms
- Xuesaitong Injection to enhance microcirculation
- Calcium Dobesilate Capsules to strengthen capillaries and protect retinal function
Eye Health Takes Center Stage
The ophthalmology team performed pan-retinal photocoagulation to stabilize the damaged blood vessels in the retina. This procedure is essential in halting the progression of diabetic retinopathy and reducing the risk of blindness. The patient also began regular monitoring of visual acuity and retinal changes.
Remarkable Recovery After Two Weeks
After 14 days of intensive, multidisciplinary treatment, the results were striking:
- Blurred vision improved significantly; visual acuity stabilized
- Numbness in both legs completely resolved
- Fasting glucose levels dropped to a healthy range of 5–7 mmol/L
- Postprandial glucose maintained between 8–9 mmol/L
One month after discharge, during outpatient follow-up, his HbA1c had decreased to 6.6%, reflecting sustained glycemic control. Both the patient and his family expressed great satisfaction with the outcome.
Ongoing Care and Lifestyle Recommendations
To maintain these gains, the medical team emphasized several key lifestyle modifications:
Dietary Management
A strict diet low in sugar, salt, and saturated fats was prescribed. Emphasis was placed on balanced meals eaten at regular intervals to avoid glucose fluctuations. Carbohydrate counting and portion control were introduced as part of daily habits.
Physical Activity
The patient was encouraged to engage in moderate-intensity aerobic exercise—such as brisk walking or light jogging—for 20–30 minutes daily, starting half an hour after meals. Exercise helps increase insulin sensitivity and supports cardiovascular health.
Glucose Monitoring and Medication Adherence
Daily self-monitoring of blood glucose (fasting and post-meal) was strongly advised. Patients should never adjust their medication doses independently. Regular clinic visits allow physicians to fine-tune therapies based on trends and lab results.
Foot and Eye Surveillance
Due to the risk of diabetic foot ulcers and infections, meticulous foot care was recommended: daily inspection, proper footwear, moisturizing dry skin, and avoiding injury. Any change in foot temperature, color, or pain while walking should prompt immediate medical review.
Annual eye exams—or more frequent if retinopathy is present—are vital to catch any recurrence or progression early.
Clinical Insights: Why Patient Education Matters
This case underscores a common challenge in chronic disease management: patient adherence. For over ten years, this individual resisted insulin therapy despite clear evidence of disease progression. It wasn't until debilitating complications arose—vision impairment and nerve damage—that he accepted comprehensive treatment.
Healthcare providers must prioritize ongoing education, empathy, and communication. Building trust encourages patients to follow treatment plans and return for timely check-ups. Additionally, clinicians must remain vigilant for potential hypoglycemia once insulin therapy begins, particularly in older adults.
Chronic diseases like type 2 diabetes and hypertension require lifelong attention. With consistent monitoring, lifestyle adjustments, and personalized medical care, it's entirely possible to prevent complications, preserve organ function, and dramatically improve quality of life.
Early detection, proactive treatment, and strong doctor-patient collaboration are not just best practices—they are lifelines for millions living with diabetes worldwide.