What is the differential diagnosis?PMH: DM with neuropathy, hyperlipidemia, HTN, 

Question Answered step-by-step What is the differential diagnosis?PMH: DM with neuropathy, hyperlipidemia, HTN, C.C. “My blood sugar has been elevated.”  HPI: M.J. 71 y.o. M reports that his blood sugars are 280-320 when he checks them. He has not been checking them lately because he ran out of testing strips. Therefore, he has not been using the sliding scale insulin three times per day. He reports increase thirst and urination. He does not count his carbohydrates but feels his diet has been “good.” Denies lightheaded, dizziness, abdominal pain, nausea or vomiting. He has been having numbness and tingling in his feet and feels worse on some days, but he denies pain or wounds.   Allergies: Lyrica: causes swelling in lower extremities (side effect)  Medication: Losartan 100 MG tablet 1 tablet orally once a day, Rosuvastatin Calcium 40 MG tablet 1 tablet orally once a day, Gabapentin 600 MG capsule 1 capsule three times a day, Metformin 1000 MG tablet 1 tablet orally twice a day, Humalog 100 UNIT/ML solution use per sliding scale (70-150: 0 Units; 125-150: 2 UNITS; 151-200 4 Units; 201-250: 6 Units; 251-300: 8 Units; 301-350: 10 Units; 351-400: 12 units. Tresiba FlexTouch 200 UNITS/ML solution pen-injector Inject 72 UNITS twice daily. Social history: Patient is single, lives with girlfriend. Denies tobacco use, recreational drug use. Drinks alcohol socially. He drinks sweet tea for caffeine intake. He is sexually active with one partner. He works full time as mechanic.  Family history: Father (deceased): CABG x2 at age 50, aortic valve replacement at age 72, Heart disease. Mother (deceased): hyperlipidemia. Paternal grandfather: deceased, heart attack and heart disease. Maternal grandfather: deceased, heart attack and heart disease. Maternal grandmother: decease, hypothyroidism, heart disease.  Health Maintenance/Promotion: Flu vaccine this year and recommended to get new Shingles vaccines (Shingrix).     Health Science Science Nursing NU 627 Share QuestionEmailCopy link Comments (0)