### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have had diabetic neuropathy for almost three years now. It has gotten progressively worse even though I keep my sugar levels under control. I am on meds for the tingling and pain and it usually works well. Lately though I have been doing some stumbling and my thighs ache and throb before my work day is over. (I am a receptionist) using a cane seems to prolong the start of discomfort but I can t walk any distance. Should I use my cane more for support? Would asking for a motorized wheelchair so I can keep up with me kids and grandkids activities wimping out or a reasonable request? Also physically exhausted by the end of my work day. Is that normal? Thank you for being there for us newbie.

### output:

Hi, I carefully passed through your question and would explain that your symptoms seem to be related to severe neuropathy. Using a cane will help improve your situation. I would not recommend using a motorized wheelchair, because it would make you avoid physical activity, which is very important for your physical performance and to maintain the function of your limbs. Anyway, I would recommend performing a Doppler ultrasound of the lower limbs vessels, to exclude possible peripheral arthropathy as a possible cause of pain and difficulty walking. Being exhausted in the end of the day could be related to the physical effort that you make every day. But, I would also recommend performing some other tests to investigate for the possible causes: - a resting ECG and a cardiac ultrasound to examine your heart- a chest X-ray study and respiratory function tests to examine your lungs-blood work (complete blood count for anemia, blood electrolytes for possible imbalance, kidney and liver function tests, HbA1C). Hope you will find this answer helpful. Let me know if I can assist you further. Best wishes, 