Physical Exam
A physical examination reveals the following:
Weight: 178 lb; height: 5′2″; body mass index (BMI): 32.6 kg/m2
Fasting capillary glucose: 166 mg/dl
Blood pressure: lying, right arm 154/96 mmHg; sitting, right arm 140/90 mmHg
Pulse: 88 bpm; respirations 20 per minute
Eyes: corrective lenses, pupils equal and reactive to light and accommodation, Fundi-clear, no arteriolovenous nicking, no retinopathy
Thyroid: nonpalpable
Lungs: clear to auscultation
Heart: Rate and rhythm regular, no murmurs or gallops
Vascular assessment: no carotid bruits; femoral, popliteal, and dorsalis pedis pulses 2+ bilaterally
Neurological assessment: diminished vibratory sense to the forefoot, absent ankle reflexes, monofilament (5.07 Semmes-Weinstein) felt only above the ankle
Lab Results
Results of laboratory tests (drawn 5 days before the office visit) are as follows:
Glucose (fasting): 178 mg/dl (normal range: 65–109 mg/dl)
Creatinine: 1.0 mg/dl (normal range: 0.5–1.4 mg/dl)
Blood urea nitrogen: 18 mg/dl (normal range: 7–30 mg/dl)
Sodium: 141 mg/dl (normal range: 135–146 mg/dl)
Potassium: 4.3 mg/dl (normal range: 3.5–5.3 mg/dl)
Lipid panel
• Total cholesterol: 162 mg/dl (normal: