A 35-year-old woman with newly diagnosed type 2 diabetes has an A1c of 8.2%. She is overweight and reports a sedentary lifestyle. Her physician recommends starting metformin. After 3 months of therapy, her A1c is still 7.8%, and she has gained 2 kg. What is the next step in management?
Read DetailsA 55-year-old man presents to the clinic for follow up. He recently established care with you and he is returning to discuss labwork results. He has an A1c of 9.5%. He is obese (BMI 32) and has a history of hypertension. He reports no symptoms. 1. What does an A1c of 9.5% indicate? 2. What is the most appropriate 1st line medication considering his profile? 3. Would your plan change if his creatinine was elevated? 4. What further diagnostics/testing/referrals would you suggest? 5. Patient education?
Read DetailsMary is a 34 year old female with no significant past history presenting to the clinic for “my heart feels like its racing and I can’t tolerate the heat.” Upon gathering history, she informs you for the past 3 months she has had the following: palpitations, unintentional weight loss, heat intolerance, anxiety/irritability, insomnia, frequent bowel movements, menstrual irregularities. She does not take any medications but does take caffeine supplements occasionally for energy. Vitals; BP 138/72, HR 112, RR 18, Temp 99.4. Exam: mild exophthalmos, lid lag present, diffuse non-tender goiter, thyroid bruit present. She is tachycardic with no murmurs with fine tremor of hands and hyperreflexia. labs show TSH
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