Mr. D is a 44 year-old male with history of hypertension and hyperlipidemia. Mr. D is a truck driver and spends majority of his day on the road. Mr. D has not exercised in years and he has put on some weight recently. Mr. D says he loves bread, anything sweet and fried. His primary care physician has been advising him to lose weight and change his diet, which he has been unsuccessful. Mr. D has been feeling tired and fatigued all the time for the past few months. He did not think much of this as he has not taken a break from work lately. Mr. D also states that he has been making frequent stops to urinate. He presents today to the clinic with symptoms including increased thirst, fatigue, blurred vision, hunger, headache and frequent urination.
Physical Exam
Weight: 228lbs height: 5’8”
BMI: 34.7 (obese)
Blood glucose: 380 mg/dl
Blood pressure: 140/66, Pulse: 70, Respiratory rate: 22, Temperature: 98.6, SPO2: 96% room air
Hemoglobin A1C: 7.8
Past Medical History
Hypertension, diagnosed age 35 years
Hyperlipidemia, diagnosed age 38 years
Medication
Carvedilol 50mg PO BID
Atorvastatin 10mg daily
Past Surgical History
No past surgical history
Allergies
No known Allergies
Pertinent Family History
Father died age 55, history of hypertension, type 2 diabetes, stroke, chronic kidney disease
Mother alive at age 68 years, history of hypertension
Sister alive and well at age 40 years
Pertinent Social History
Works as a truck driver for the past 12 years
Non-smoker
Occasional beer drinker