My mother had a very bad foot ulcer and now is healing pretty well, but she has lost her appetite and can’t eat. Also, her neck is getting very stiff which I worry could be kidney failure. She lives in Africa and we have put her in the best hospital. Please tell me how my mum can get her appetite back and get better. She also loses her mind sometimes as she talks without realizing what she is talking about. Basically, she is also confused. I am very worried

Foot ulcers can occur when there is inadequate blood flow to heal an ulcer, decreased sensory nerve function to protect it from re-injury, or poor blood sugar control to delay healing. All of these can occur in the setting of a person with diabetes and multiple end-organ complications. The most common complications involve the nerves, the eyes, and the kidneys. However, it is not clear that just because someone has a foot ulcer that they have kidney failure. The neck swelling does not clearly indicate kidney failure to me. A person with diabetes routinely has their kidney function monitored through blood and urine tests. When kidney involvement is present, it does make the management of the patient more complicated. Again, I do not see that neck stiffness is directly related to kidney failure.

As far as inability to eat, this is also a vague issue and needs more clarity. People who are chronically ill sometimes develop a chronic loss of appetite. The loss of appetite is related to the production of chemicals in their body that keep them from desiring food. This is different than someone who has chronic nausea, which can occur with diabetes. It also has to be separated out from her refusal to eat because she is afraid the food will raise her blood sugars.

I think it would be important for you to get additional information from your mother and let us know. I would be glad to comment on any further information you forward to us in the future.

JTL