38 year old Diabetic woman with progressive blindness

A 38 year old woman presented with the complaints of 
Progressive Blurring of vision in both her eyes since 2 years 
Polyuria and polydypsia since 2 months 
She attained menarche at 14 years of age and got married to an auto driver. Her last menstrual cycle was on Nov 14th 2020, and has regular cycles for 3 days every month. She has 2 children, her elder daughter is married and her son works as an auto driver. 
5 years back, she fell out from an running auto at Miryalgudem following which she had a head trauma, they were unable to recall exactly  what was said to them but they were told that they had nothing to worry about. 
 2 years back, one day she suddenly developed blurring of vision in her left eye which gradually progressed and she started developing rapidly progressive blindness in her right eye as well. 
8 months back, she had bilateral pedal edema which was sudden in onset extending to her knees, she visited Gandhi hospital where in she was told that she had Diabetes and she was put on medications which she used only for 1 week and discontinued it. 

Over the last 2 months, she complaints of polyuria, polydypsia, tingling in both her lower limbs upto her knees on and off. She says she has to wake up multiple times to use the washroom at night.
Over the last 10 days, her blindness has increased so she decided to visit our ophthalmologist. On routines, her RBS was found to be around 500mg/dl and she was even diagnosed to be HBsAg positive. 
She was told that she had to get her blood sugars under control to get operated. 
PR - 64bpm
Bp - 110/70mmhg 
Grbs on presentation - 150mg/dl
CNS :
Power - 5/5 in all limbs
Reflexes       Right.      Left 
UL. 
B.                    2+.          2+
T.                     2+.          2+
S.                     2+.          2+
LL
K                      2+.         2+
A                       +.           +
Plantars withdrawal 
 Sensory system - 
Vibration, proprioception intact 
Pain, soft and crude touch, temperature, intact 
CVS - S1,S2 +
Respiratory system - clear 
Per abdomen - soft , non tender
Bowel sounds +
Hemogram
cue
Fbs
Plbs
urine for ketones
Grbs charting
Diagnosis
K/c/o type 2 DM
B/L mature cataract
HBsag positive
Treatment
1.Inj.optineuron 1amp in 100ml NS Iv/bd
2.Tab.Glimi M1 BD
8Am(1tab)-8pm(1/2 tab)
3.Tab Pregabalin 75mg/po/hs 8pm


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