Patient V is a Hispanic man, 61 years of age, presenting to the primary care nurse practitioner with complaints o

CASE STUDY

Patient V is a Hispanic man, 61 years of age, presenting to the primary care nurse practitioner with complaints of polydipsia, polyphagia, and fatigue for the past month. Upon further assessment, he states that he has recently had his eyeglass prescription adjusted due to blurred vision. He is 5 feet 10 inches tall and weighs 245 pounds; his calculated BMI is 35.2 kg/m2. The patient reveals a family history of diabetes. He works a physical job in a warehouse lifting 50-pound boxes. He occasionally golfs. A random finger stick reveals a blood glucose level of 220 mg/dL.

Patient V's fasting blood work reveals the following:

• HbA1c: 8.7% (estimated average glucose: 203 mg/dL)
• Fasting blood glucose: 151 mg/dL
• Two-hour glucose level (after 75 g oral glucose tolerance test): 233 mg/dL
• Total: 250
• Triglycerides: 210 mg/dL
• LDL: 112 mg/dL
• HDL: 35 mg/dL
• Liver function tests: Within normal limits
• Renal function: Within normal limits