TY - CHAP M1 - Book, Section TI - Chapter 219. Diabetes Overview A1 - Usatine, Richard P. A1 - Smith, Mindy A. A1 - Chumley, Heidi S. A1 - Mayeaux, E.J. PY - 2013 T2 - The Color Atlas of Family Medicine, 2e AB - A 66-year-old man with obesity and mild hypertension controlled with a diuretic presents with increasing nocturia and excessive thirst. He has no other urinary symptoms and denies any visual problems. His mother had diabetes and died at age 85 years from a heart attack. His only other concern is a recurrent fungal infection on his feet. His blood pressure in the office today is 135/85 mm Hg and his finger stick blood sugar is 220 mg/dL. You explain that based on his elevated blood sugar, he has diabetes mellitus. Physical exam findings confirm the diagnosis of tinea pedis (Figure 219-1). A monofilament test demonstrates normal sensation in his feet. You order a fasting blood sugar, lipid profile, serum electrolytes, creatinine, and hemoglobin A1C. You ask him to return next week for a more complete examination, review of his test results, and diabetes education. You ask him and his wife to consider meeting with a nutritionist, and briefly review treatment options, including diet, exercise, and metformin, as well as a possible need to improve his blood pressure control or switch to another agent. You suggest a nonprescription antifungal cream and will see if he needs additional treatment for his feet at follow-up. The patient is referred to an ophthalmologist who finds diabetic nonproliferative retinopathy (Figure 219-2). SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=57685086 ER -