Butch’s conditions in about three months will head for the worse especially if his living and diet conditions do not change. He has already lost some toes and is experiencing green pus from his big stub from where his big toe came off. People with diabetes may develop poor circulation which slows the process of nutrients getting to a wound for healing. This means that Butch’s wound will take longer than normal to heal. That couple with poor hygiene in the streets means the wound may be exposed to secondary infections.

He cold experienced while living on the streets is detrimental for diabetes patients. Butch does not have any warm clothing or good shoes for the cold. Generally a drop in temperature causes a rise in blood sugar as the liver releases glucose for energy and to keep the body warm. The rise in blood sugar is a concern for diabetic people. The situation for Butch is worsened by his smoking and drinking habits. Smoking may cause a rise in blood sugar levels and lead to insulin resistance. Alcohol on the other hand impairs the ability of the pancreas from secreting insulin which controls blood sugar.

Diabetes is a chronic condition that requires constant medical care and treatment to control the blood sugar levels. Butch does not have access to consistent medical care and runs the risk of developing blindness, kidney failure, amputations, blindness and even heart disease from the disease.

If Butch does not change his living and diet conditions, he stands the risk of developing diabetic neuropathy. This condition caused by nerve damage in people with uncontrolled diabetes mostly affects the legs and feet but can also affect the digestive system. The condition causes numbness in the legs and can be painful and disabling (Pop-Busui et. al., 2016).

Reference

Pop-Busui, R., Boulton, A., Feldman, E., Bril, V., Freeman, R., & Malik, R. et al. (2016). Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care, 40(1), 136-154. https://doi.org/10.2337/dc16-2042