Patient Case Presentation

 

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