Download The patient is a 64 years old male who comes in for evaluation of

The patient is a 64 years old male who comes in for evaluation of DM Type 2. He
has not been enrolled in the "Diabetic Education Program". He states
understanding of dietary principles and is following his diet appropriately. Sensory
loss is noted. Self foot exams are being performed. He is checking home blood
sugars. He says that he is exercising.
Reported hypoglycemic symptoms include confusion. Frequency of
hypoglycemic symptoms are reported to be seldom. No hyperglycemic symptoms
are reported.
There are no symptoms to suggest diabetic complications. No changes have
been made to his treatment plan since last visit.
Problem # 1: DIABETES MELLITUS, TYPE II, ON INSULIN (ICD-250.00)
Assessment: Improved
A1c under 10!
add januvia
decrease lantus to 75u initially to avoid hypoglycemeia then increase back to 90
based on BG
consider Helwig
watch for s/s depression with chronic illness and wife's death a year ago
discussed wgt loss
HEMOGLOBIN A1c 9.7 %
The following medications were removed from the medication list:
Januvia 100 Mg Tabs (Sitagliptin phosphate) ..... Take 1 tab daily