Problem
42-year-old female who presents to your primary care office for her complete physical. lLast seen approximately one year ago for her physical and diagnosed her with type II diabetes. Her hemoglobin A1C was 6.9 at that time and she refused medications, stating she would change her diet and begin to exercise. She agreed to follow up with you in three months for a repeat hemoglobin A1C but never came for follow up.
Her vital signs are at present: Height: 66.25″, weight: 185 lbs. (down 23 lbs from last visit), BP: 132/86, P: 88, RR: 18, temp: 98.9, O2: 98% RA
Her labs values come back as follows: A1C: 7.6, total chol: 195, LDL: 90; HDL: 27, trigs: 120; LFTS: normal, TSH: 1.70, uric acid: 7.2
After reading the case study, respond to the following prompts:
Based on her most recent labs, list two differential diagnoses with cited rationale. Then select a medical diagnosis and write a plan of care including each of the following:
A. What primary prevention is important for this patient? What secondary prevention for this patient is important?
B. An explanation to the patient about her recent lab values
C. A list of appropriate medications to treat (if applicable) each condition as well as their dosing based on the current guidelines
D. Any follow-up testing - lab or diagnostic (if applicable) and when those need to be done
E. Any referrals (if applicable)