Charlotte Martin is a 49-year-old Caucasian female in for a

Charlotte Martin is a 49-year-old Caucasian female in for a follow-up visit. She was diagnosed with Type II Diabetes approximately 10 months ago. Since her diagnosis, A1C has dropped from 10.5% to 9% and she has lost about 15 pounds. She says that she is feeling well, trying to eat healthy and exercises at least 2-3 days a week. BP checks at home average 140-150 systolic and 80-90 diastolic. Charlotte says that her BS are still a bit elevated—AM glucoses about 140 mg/dL and postprandial BS about 210-235 mg/dL. She denies polydipsia, polyuria and polyphagia. Her last eye exam was 6 months ago and it was normal. She does daily feet exams and reports no problems. PMH: Type 2 DM, Obesity, Dyslipidemia, HTN, Polycystic Ovarian Syndrome No previous surgeries; no allergies Meds: Metformin ER 1000 mg BID ac meals; Lisinopril 10 mg; Crestor 10 mg; Multi-Vitamin [1] per day; Calcium 1000 mg daily [because she does not like milk]; Vitamin D3 2000 IU daily. PE today reveals a pleasant, well-groomed female—in no acute distress. Her VS are as follows: 98.6 80-16 148/92 67 inches tall 185 pounds On exam, lungs are clear. Heart is regular in rate and rhythm without murmurs, gallops are rubs. No carotid bruits. There is no peripheral edema; pt and dp pulses are 2+ bilaterally. There are no feet lesions; nails are smooth and flat; vibratory sensation is intact and normal with both the tuning fork and the Semmes Weinstein monofilament. Fasting labs that were obtained yesterday: A1C 8.9% FBS 150 mg/dL CMP—all normal [K+ 4.2; creatinine 0.9 mg] UA 1+ proteinuria CBC, TSH normal Lipid Panel—TC 220 mg/dL HDL 30 LDL 128 Trigs 220 mg

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